Lake of the Ozarks Developmental Center

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

15428899 Issued in MO

Legal business name

LAKE OF THE OZARKS DEVELOPMENTAL CENTER

Practice address

1867 South State Highway 5
Camdenton, MO 65020

Phone

(573) 346-4574

Fax

(573) 346-7426

NPI assigned

Mar 15, 2007

Last updated

Aug 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn Leigh Martin

Title

Executive Director

Phone

(573) 346-4574

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1871627448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 753",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650200753",
            "telephone_number": "573-346-4574",
            "fax_number": "573-346-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 SOUTH STATE HIGHWAY 5",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "65020",
            "telephone_number": "573-346-4574",
            "fax_number": "573-346-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE OF THE OZARKS DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-346-4574",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MO",
            "license": "15428899",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "15428899",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MO",
            "license": "15428899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Kosov, M.D.
• Terry S Krantz, RN FNP
• Lake Area Citizens' Advisory Board, Inc. (Lake Area Counseling & Behavioral Health)
• Lake Area Industries, Inc.
• Lake Dental Clinic LLC
• Lake of the Ozarks Laser Pain Center LLC (Back To Life Laser Pain Center)
• Lake Professional Hearing Aid Center
• Lake Regional Health System (Lake Regional Express Care-Camdenton)
• Lake Regional Health System (Lake Regional Pharmacy - CMC)
• Lake Regional Health System (Lake Regional Clinic - Camdenton)

• Developmentally Disabled Services Day Training Agency in Camdenton, MO
• Providers in Camdenton, MO by specialty
• Developmentally Disabled Services Day Training Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.