NPIMap

Organization Active NPI

Northwest Missouri Living Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Tarkio, MO
National Provider Identifier
1851438907
Registry record updated Apr 1, 2016
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
NORTHWEST MISSOURI LIVING CENTER
Practice address
302 Maple St
Tarkio, MO 64491-1342
Phone
(660) 736-5523
Fax
(660) 736-4884
NPI assigned
Jan 30, 2007
Last updated
Apr 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Mrs. Crystal Ann Woodring
Title
Director
Phone
(660) 736-5523

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MW 01168 MO
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

302 Maple St
Tarkio, MO 64491-1342

Mailing address

302 Maple Street
Tarkio, MO 64491
Phone (660) 736-5523

Other identifiers 1

IdentifierTypeStateIssuer
855331609MedicaidMO

Other names 1

  • Northwest MO Learning Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Northwest Missouri Learning Center Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1851438907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MAPLE STREET",
            "city": "TARKIO",
            "state": "MO",
            "postal_code": "64491",
            "telephone_number": "660-736-5523",
            "fax_number": "660-736-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MAPLE ST",
            "city": "TARKIO",
            "state": "MO",
            "postal_code": "644911342",
            "telephone_number": "660-736-5523",
            "fax_number": "660-736-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MISSOURI LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "WOODRING",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "660-736-5523",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "MW 01168",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "855331609",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest MO Learning Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tarkio, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.