NPIMap

Organization Active NPI

Doulos Ministries, Inc.

Doing business as Shelterwood

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Independence, MO
National Provider Identifier
1922337583
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
002135344 Issued in MO
Legal business name
DOULOS MINISTRIES, INC.
Doing business as
Shelterwood
Practice address
3205 N Twyman Rd
Independence, MO 64058-3211
Phone
(816) 249-5350
NPI assigned
Dec 10, 2009
Last updated
May 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Authorized official

Name
Dr. Jessica Wood, PSY.D
Title
Clinical Director
Phone
(816) 249-5350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 002135344 MO Primary

Addresses

Primary practice location

3205 N Twyman Rd
Independence, MO 64058-3211

Mailing address

3205 N Twyman Rd
Independence, MO 64058-3211
Phone (816) 249-5350

Other identifiers 1

IdentifierTypeStateIssuer
002135344OtherMOSTATE LICENSE

Other names 1

  • Shelterwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Doulos Ministries Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557878400000",
    "number": "1922337583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N TWYMAN RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640583211",
            "telephone_number": "816-249-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 N TWYMAN RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640583211",
            "telephone_number": "816-249-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOULOS MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2019-05-15",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "816-249-5350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": "002135344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "002135344",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelterwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.