1285906107 NPI number — THE ARC OF THE OZARKS

Table of content: (NPI 1285906107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285906107 NPI number — THE ARC OF THE OZARKS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE ARC OF THE OZARKS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CORNERSTONE PSYCHOLOGICAL SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285906107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1721 W. ELFINDALE ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65807-2139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-874-1942
Provider Business Mailing Address Fax Number:
417-771-3723

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1721 W ELFINDALE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65807-1295
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-874-1942
Provider Business Practice Location Address Fax Number:
417-771-3723
Provider Enumeration Date:
02/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
POWERS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
417-864-7887

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1093134231 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1184993750 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1285906107 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407098254 . This is a "NPI" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1952602468 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1497093488 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1871039404 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134664659 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1003236977 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1215295050 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1477617967 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1134521131 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 107377257 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1417496605 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com