Ambrose Park Residential Care Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

037166 Issued in MO

Legal business name

AMBROSE PARK RESIDENTIAL CARE FACILITY

Practice address

517 North Oak Street
Cole Camp, MO 65325

Phone

(660) 668-3140

Fax

(660) 668-0108

NPI assigned

Jul 27, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Rexanna Kay Kreisel, R.N.

Title

Owner

Phone

(660) 668-3140

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1962633818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "COLE CAMP",
            "state": "MO",
            "postal_code": "653250252",
            "telephone_number": "660-668-3140",
            "fax_number": "660-668-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 NORTH OAK STREET",
            "city": "COLE CAMP",
            "state": "MO",
            "postal_code": "65325",
            "telephone_number": "660-668-3140",
            "fax_number": "660-668-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBROSE PARK RESIDENTIAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "KREISEL",
        "authorized_official_first_name": "REXANNA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-668-3140",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "037166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Absolute Care Therapy LLC
• Anew Healthcare Operations - Cole Camp, LLC
• Christine Armantrout
• Back in Action Chiropractic LLC
• Bothwell Regional Health Center
• Cole Camp Community Ambulance District

• Assisted Living Facility in Cole Camp, MO
• Providers in Cole Camp, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.