WILLOW CREEK GROUP HOME INC. NPI 1922141068

NPI Information

NPI: 1922141068
Provider Name: WILLOW CREEK GROUP HOME, INC.
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
RR 2 BOX 27
ADRIAN, MO
ZIP 64720
Phone: (816) 297-8956
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WILLOW CREEK GROUP HOME, INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Adrian, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. WILLOW CREEK GROUP HOME, INC. NPI is 1922141068. The provider is registered as an organization entity type.

The provider's business location address is:

RR 2 BOX 27
ADRIAN, MO
ZIP 64720-587
Phone: (816) 297-8956
Fax: (816) 297-4032

The provider's authorized official is Jeanie Sue Stephens .
The authorized official title is Owner and has the following contact phone number (816) 297-8956.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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