Colonial House of Crystal City, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

COLONIAL HOUSE OF CRYSTAL CITY, LLC

Practice address

26 Mississippi Ave
Crystal City, MO 63019-1817

Phone

(636) 937-1000

Fax

(636) 937-1003

NPI assigned

Mar 30, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Alysha Lynn Sauer

Title

Member

Phone

(636) 933-4911

Specialties & licenses 1

Addresses

Other names 1

• Colonial House of Crystal City Former legal business name

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1962644401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WEST AVE",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281733",
            "telephone_number": "636-933-4911",
            "fax_number": "636-933-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MISSISSIPPI AVE",
            "city": "CRYSTAL CITY",
            "state": "MO",
            "postal_code": "630191817",
            "telephone_number": "636-937-1000",
            "fax_number": "636-937-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL HOUSE OF CRYSTAL CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "SAUER",
        "authorized_official_first_name": "ALYSHA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "636-933-4911",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial House of Crystal City",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christopher M Cabral, PT, DPT
• Jessica Cantrell, MA, LPC
• Kristin J Charlesworth, PLPC
• Darcy M Clawson, P.A.-C
• Talon Colby
• Compass Health, Inc
• Compass Health, Inc
• Roberta J Crawford, O.D.
• Crystal City Emergency Services, LLC
• Crystal City School District

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Crystal City, MO
• Providers in Crystal City, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.