Laci'S Haven

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

LACI'S HAVEN

Practice address

713 Salem Ave
Suite E
Rolla, MO 65401-3444

Phone

(573) 465-3654

Fax

(888) 858-8055

NPI assigned

Jun 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Lewis, RN

Title

Director, Administrator, President

Phone

(573) 201-8654

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad Lewis, BCBA, LBA

  • Behavior Analyst
  • Rolla, MO
  • NPI 1083024475
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1730527904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 SALEM AVE",
            "address_2": "SUITE E",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013444",
            "telephone_number": "573-201-8654",
            "fax_number": "888-858-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 SALEM AVE",
            "address_2": "SUITE E",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013444",
            "telephone_number": "573-465-3654",
            "fax_number": "888-858-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACI'S HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR, ADMINISTRATOR, PRESIDENT",
        "authorized_official_telephone_number": "573-201-8654",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judyann Krenning, M.D.
• Brian Robert Kriete, M.D.
• Lynne Marie Kuhn, MACCC-SLP
• Glenn A. Kunkel, MD
• Florence Gotico Kwan, OTR
• Brandon Lamberth, NP-C
• Salli Lamberth, NP
• Sarah Elizabeth Lea, PHD
• Bohdan A Lebedowicz, MD
• Lindsey Renee Lebel

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rolla, MO
• Providers in Rolla, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.