Mkalma, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MKALMA, LLC

Doing business as

Holiday Residential Care

Practice address

1019 Old Saint Marys Rd
Perryville, MO 63775-1298

Phone

(573) 768-5155

Fax

(573) 547-6246

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Di Di Terbrak, RN

Title

Owner/Administrator

Phone

(573) 768-5155

Specialties & licenses 1

Addresses

Other names 1

• Holiday Residential Care Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1750955209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 OLD SAINT MARYS RD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751298",
            "telephone_number": "573-768-5155",
            "fax_number": "573-547-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 OLD SAINT MARYS RD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751298",
            "telephone_number": "573-768-5155",
            "fax_number": "573-547-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKALMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "TERBRAK",
        "authorized_official_first_name": "DI DI",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "573-768-5155",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holiday Residential Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Perryville, MO
• Providers in Perryville, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.