Shalimar Corp. D/B/a Parkwood Manor

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

371-7545 Issued in MO

Legal business name

SHALIMAR CORP. D/B/A PARKWOOD MANOR

Doing business as

Parkwood Manor

Practice address

325 N Sprigg St
Cape Girardeau, MO 63701-5531

Phone

(573) 334-7011

Fax

(573) 334-7011

NPI assigned

Feb 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gale A Lacy

Title

Office Manager

Phone

(573) 335-3044

Specialties & licenses 1

Addresses

Other names 1

• PARKWOOD MANOR Doing business as

Tax ID family

Parkwood Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shalimar Corp

  dba Parkwood Manor

  • Mental Illness Community Based Residential Treatment Facility
  • Cape Girardeau, MO
  • NPI 1568541886
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Jo Becker, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Festus, MO
  • NPI 1194221200
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760457683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2732 BLOOMFIELD RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036302",
            "telephone_number": "573-335-3044",
            "fax_number": "573-335-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SPRIGG ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015531",
            "telephone_number": "573-334-7011",
            "fax_number": "573-334-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALIMAR CORP. D/B/A PARKWOOD MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LACY",
        "authorized_official_first_name": "GALE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-335-3044",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": "371-7545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKWOOD MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Renee Seyer, FNP-C
• Nathan Thomas Seyer, D.D.S.
• Christi Ann Shafer, RD, LD
• Krista Shaffer
• Shalimar Corp (Parkwood Manor)
• Shamrock Dental Group, LLC
• James Daniel Shandy, BC-HIS
• Katheryne Jenna Sharp, BCBA
• Teena L Sharrock, MD
• Zachary Shaw, AU.D.

• Assisted Living Facility (Mental Illness) in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Assisted Living Facility (Mental Illness) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.