Mason's Place Too, LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

MASON'S PLACE TOO, LLC

Practice address

125 N Ruby LN # 2
Fairview Heights, IL 62208-1926

Phone

(618) 489-1129

Fax

(618) 213-6082

NPI assigned

Jun 15, 2023

Organization subpart

No

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

Authorized official

Name

Trena McCoy

Title

Ceo/Partner

Phone

(618) 489-1129

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686787200000",
    "number": "1750066981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N RUBY LN # 2",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081926",
            "fax_number": "618-213-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N RUBY LN # 2",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622081926",
            "telephone_number": "618-489-1129",
            "fax_number": "618-213-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASON'S PLACE TOO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "TRENA",
        "authorized_official_title_or_position": "CEO/PARTNER",
        "authorized_official_telephone_number": "618-489-1129"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lauren Mapes
• Karen D March, O.D.
• Kelly Louis Marler, RPH
• Catrina S Martin
• Eduardo Martinez-Barrios, MD
• Sonya Masterson, LCSW
• Maxim Healthcare Services, Inc.
• Shawn Allen May, DDS
• Karin Elizabeth Mayberry, PSYD
• Ryan McCafferty, DC

• Developmental Disabilities Clinic/Center in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Developmental Disabilities Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.