NORTHSTAR RESIDENTIAL CARE, INC. (NPI# 1477672426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477672426 |
| Entity Type | Organization |
| Organization Name | NORTHSTAR RESIDENTIAL CARE, INC. |
| Practice Address |
18805 Hanthorne Dr Independence MO 64057-1676 |
| Practice Telephone | 8167957652 |
| Practice Fax Number | 8167950163 |
| Mailing Telephone | 8167957652 |
| Mailing Fax Number | 8167950163 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID BRADLEY NORTH (DIRECTOR) |
| Authorized Official Telephone | 8167957652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154440402 | Northstar Residential Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1900 Nw Manor Dr, Blue Springs, MO 64014-1755 | 2007-03-28 |
| 1659490704 | Northstar Residential Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18208 E 27th St S, Independence, MO 64057-1506 | 2007-03-28 |
| 1891814117 | Northstar Residential Care, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 201 Sw 6th Street, Blue Springs, MO 64014 | 2007-03-28 |
| Street Address |
18805 HANTHORNE DR |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64057-1676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174002364 | Justine Barye Bolton | Physical Therapist | 2301 South 291 Highway, Independence, MO 64057 | 2018-08-09 |
| 1194230136 | Brantley Vincent Niendick | Occupational Therapist | 2301 S M 291 Hwy, Independence, MO 64057 | 2017-12-13 |
| 1437693561 | Derek Faulkner | Counselor | 2400 Little Blue Pkwy, Independence, MO 64057 | 2016-12-08 |
| 1578916136 | Jared Donald Gerstenkorn | Physical Therapist | 2301 South Highway 291, Independence, MO 64057 | 2016-07-19 |
| 1295198182 | Jennifer J Allen | Nurse Practitioner | 2310 Castle Drive, Independence, MO 64057 | 2016-03-30 |
| 1750750808 | Lisa Louise Freeman | Physical Therapy Assistant | 3980 S Jackson Dr, Independence, MO 64057 | 2015-09-18 |
| 1437543592 | Harold Epps | Specialist/Technologist | 2301 South Mo 291 Highway, Independence, MO 64057 | 2015-03-26 |
| 1245620426 | Holly Morgan | Occupational Therapist | 3980 S Jackson Dr., Independence, MO 64057 | 2015-01-27 |
| 1093128159 | Jennifer Falk Crumbaugh | Dentist | 3151 S. M-291 Highway, Suite A, Independence Mo, MO 64057 | 2014-06-06 |
| 1952711954 | Judy Bray | Occupational Therapy Assistant | 3980 East Jackson Drive, Independence, MO 64057 | 2014-04-30 |
| Find all providers in zip 64057 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750738084 | Building On Dreams | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 638 Rockwell Ave, Independence, MO 64056-3132 | 2016-05-17 |
| 1518245745 | Harry S Truman Childrens Neurological Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12404 E Us Highway 40, Independence, MO 64055-5954 | 2011-07-21 |
| 1598083867 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 27683 Ivy Springs Dr, Independence, LA 70443-4927 | 2010-05-12 |
| 1386967495 | Care By Cassie Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 500 E Bellevista Dr, Independence, MO 64055-1748 | 2010-03-03 |
| 1932432291 | Care By Cassie, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3514 S Cottage Ave, Independence, MO 64055-3133 | 2009-09-17 |
| 1033383641 | Community Access | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1402 S Lees Summit Rd, Independence, MO 64050-4117 | 2008-04-15 |
| 1164601357 | Care By Cassie | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3816 S Union St, Independence, MO 64055-3150 | 2007-10-24 |
| 1760681415 | State of Missouri | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1501 N River Blvd, Independence, MO 64050-1760 | 2007-07-13 |
| 1366640914 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1215 W. Truman Rd, Independence, MO 64050 | 2007-07-05 |
| 1558569103 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3704 S. Blue Ridge Blvd, Independence, MO 64052 | 2007-07-05 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64057 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.