NPIMap

Organization Active NPI

Tri-County Center for Independent Living

  • Case Management Agency
  • Rolla, MO
National Provider Identifier
1750638656
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
TRI-COUNTY CENTER FOR INDEPENDENT LIVING
Practice address
1420 E State Route 72
Rolla, MO 65401-3988
Phone
(573) 368-5933
Fax
(573) 368-5991
NPI assigned
Aug 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Authorized official

Name
Mr. Douglas Williams
Title
Executive Director
Phone
(573) 368-5933

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1420 E State Route 72
Rolla, MO 65401-3988

Mailing address

1420 E State Route 72
Rolla, MO 65401-3988
Phone (573) 368-5933

Other identifiers 1

IdentifierTypeStateIssuer
276236205MedicaidMO

Other names 1

  • Home Outreach for Personal Excellence Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri-County Center for Independent Living5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390176000000",
    "number": "1750638656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013988",
            "telephone_number": "573-368-5933",
            "fax_number": "573-368-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E STATE ROUTE 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013988",
            "telephone_number": "573-368-5933",
            "fax_number": "573-368-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY CENTER FOR INDEPENDENT LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2014-01-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-368-5933",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276236205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Outreach for Personal Excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; 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.