NPIMap

Organization Active NPI

Bethesda Lutheran Homes & SVCS Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kirkwood, MO
National Provider Identifier
1780874057
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
BETHESDA LUTHERAN HOMES & SVCS INC
Practice address
1019 S Geyer Rd
Kirkwood, MO 63122-7105
Phone
(314) 821-2986
NPI assigned
Aug 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Mr. Jeff Kaczmarski
Title
Corporate Lawyer
Phone
(920) 261-3050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

1019 S Geyer Rd
Kirkwood, MO 63122-7105

Mailing address

600 Hoffmann Dr
Watertown, WI 53094-6223
Phone (920) 261-3050

Other identifiers 1

IdentifierTypeStateIssuer
856131206MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Ablelight Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1780874057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HOFFMANN DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946223",
            "telephone_number": "920-261-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 S GEYER RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227105",
            "telephone_number": "314-821-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA LUTHERAN HOMES & SVCS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "KACZMARSKI",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CORPORATE LAWYER",
        "authorized_official_telephone_number": "920-261-3050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "856131206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.