NPIMap

Organization Active NPI

Missouri Girls Town Foundation, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Kingdom City, MO
National Provider Identifier
1831253137
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
MISSOURI GIRLS TOWN FOUNDATION, INC
Practice address
8548 Jade Road
Kingdom City, MO 65262
Phone
(573) 642-5345
Fax
(573) 642-0891
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Roy Fowles
Title
Executive Director
Phone
(573) 642-5345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MO Primary

Addresses

Primary practice location

8548 Jade Road
Kingdom City, MO 65262

Mailing address

PO Box 59
8548 Jade Road
Kingdom City, MO 65262-0059
Phone (573) 642-5345

National Provider Directory

National Provider Directory
Tax ID family
Missouri Girls Town Foundation Inc2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831253137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 59",
            "address_2": "8548 JADE ROAD",
            "city": "KINGDOM CITY",
            "state": "MO",
            "postal_code": "652620059",
            "telephone_number": "573-642-5345",
            "fax_number": "573-642-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8548 JADE ROAD",
            "city": "KINGDOM CITY",
            "state": "MO",
            "postal_code": "65262",
            "telephone_number": "573-642-5345",
            "fax_number": "573-642-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI GIRLS TOWN FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOWLES",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-642-5345",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingdom City, MO

Sources for this page

  • 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.