Lisa Kristine Sutter
Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Palmyra, MO
NPI 1780708784 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780708784
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- Practice address
- 5051 Highway C
Palmyra, MO 63461-2902 - Phone
- (573) 769-2640
- NPI assigned
- Mar 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TLC Sutter Home | Residential Treatment Facility, Intellectual and/Or Developmental Disabilities | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Yes |
Addresses
Primary practice location
5051 Highway C
Palmyra, MO 63461-2902
Mailing address
5051 Highway C
Palmyra, MO 63461-2902
Phone (573) 769-2640
Other providers in Palmyra, MO
- Shelby Steidinger
- Steinbrueck Chiropractic Health Center, LLC
- Randy E Steinbrueck
- Codey Stephens
- John Scott Stiffey
- Amy Elizabeth Swaters
- Carrie Thomas
- TLC Sutter Home
- Lesley Anne Turner
- United Vitality Health
All providers in Palmyra, MO · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.