NPIMap

Organization Active NPI

Mracles Residential Care LLC-Fall House

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Kansas City, MO
National Provider Identifier
1861664591
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
MRACLES RESIDENTIAL CARE LLC-FALL HOUSE
Practice address
1130 E 75TH Ter
Kansas City, MO 64131-1901
Phone
(816) 521-8896
Fax
(816) 521-8896
NPI assigned
Apr 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Authorized official

Name
Ms. Dedree Renee Carlisle
Title
Administrator
Phone
(816) 521-8896

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1130 E 75TH Ter
Kansas City, MO 64131-1901

Mailing address

1130 E 75TH Ter
Kansas City, MO 64131-1901
Phone (816) 521-8896

National Provider Directory

National Provider Directory
Tax ID family
Mracles Residential Care LLC - Johnson House4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381881600000",
    "number": "1861664591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E 75TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311901",
            "telephone_number": "816-521-8896",
            "fax_number": "816-437-7027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E 75TH TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641311901",
            "telephone_number": "816-521-8896",
            "fax_number": "816-521-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRACLES RESIDENTIAL CARE LLC-FALL HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2013-10-16",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "DEDREE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "816-521-8896",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.