Mashburn Residential Learning Center

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

14209362 Issued in MO

Legal business name

MASHBURN RESIDENTIAL LEARNING CENTER

Practice address

807 N Briarwood Dr
Bolivar, MO 65613-1281

Phone

(417) 326-6512

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Linda L Mashburn

Title

Owner

Phone

(417) 326-6512

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831248517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 N BRIARWOOD DR",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131281",
            "telephone_number": "417-326-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 N BRIARWOOD DR",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131281",
            "telephone_number": "417-326-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASHBURN RESIDENTIAL LEARNING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASHBURN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-326-6512"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "14209362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Marsolf, PHARM.D
• Allison Martin, OTR
• Bethany M Martin, FNP-C
• Jared John Martin, FNP-BC
• Olivia Martin
• Murphy Remsen Mastin, MD
• Diane M McClaskey, RPH, BCPS
• Chastity McCullick, APRN
• Robert Lee McGowin Jr., PA-C
• Wanda McHaffie

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility 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.