Twin Lakes Community Support Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

TWIN LAKES COMMUNITY SUPPORT SERVICES, LLC

Practice address

16727 Walnut Grove Rd
Warsaw, MO 65355-5750

Phone

(660) 438-8599

Fax

(660) 438-8584

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Earl Watson, BSSP

Title

Director

Phone

(660) 438-8599

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942363361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16727 WALNUT GROVE RD",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653555750",
            "telephone_number": "660-438-8599",
            "fax_number": "660-438-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16727 WALNUT GROVE RD",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653555750",
            "telephone_number": "660-438-8599",
            "fax_number": "660-438-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN LAKES COMMUNITY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "660-438-8599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSSP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMH VENDER NUMBER",
            "identifier": "8001556",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Warsaw, MO
• Providers in Warsaw, 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 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.