PROCARE ISL, LLC (NPI# 1598323115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598323115 |
| Entity Type | Organization |
| Organization Name | PROCARE ISL, LLC |
| Practice Address |
2040 Woodson Rd Ste 203b Overland MO 63114-5606 |
| Practice Telephone | 3147551444 |
| Practice Fax Number | 3147551446 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | TIGRE SMITH (OWNER) |
| Authorized Official Telephone | 3147570188 |
| 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 |
| Street Address |
2040 WOODSON RD STE 203B |
| City | OVERLAND |
| State | MO |
| Zip Code | 63114-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926964 | Deann Porter | Prosthetist | 8743 Mavis Place, St Louis, MO 63114 | 2020-09-09 |
| 1255971438 | Hughes In Home Services | Home Health | 9319 Midland Ste B, St Louis, MO 63114 | 2020-01-15 |
| 1740714724 | Catherine Kagotho | Nurse Practitioner | 9915 Broadmoor Dr, Apt 4, Overland, MO 63114 | 2017-04-17 |
| 1073051371 | Ruth & Naomi Adult Day Services, Inc | Clinic/Center | 9443-9445 Lackland Road, St. Louis, MO 63114 | 2017-02-07 |
| 1992103691 | Lisa Abernathy | Social Worker | 9705 Tennyson Court, Saint Louis, MO 63114 | 2014-12-11 |
| 1356626808 | William J Norbury | Pharmacist | 8000 St. Charles Rock Road, Walgreens Pharmacy 4825, St.louis, MO 63114 | 2011-10-17 |
| 1770719700 | Total Renal Care Inc | Clinic/Center | 9030 Saint Charles Rock Rd, Saint Louis, MO 63114 | 2009-06-04 |
| 1710126792 | Risingabove Independent Supported Living | Assisted Living Facility | 2330 # 2 Woodson Road, Overland, MO 63114 | 2009-02-13 |
| 1427215789 | Wnf Medical, LLC | Durable Medical Equipment & Medical Supplies | 1908-2000 Innerhelt Business Center Dr., Suite 1968, Overland, MO 63114 | 2008-05-22 |
| 1891838744 | Easter Seals Midwest | Day Training, Developmentally Disabled Services | 2215 Lackland Road, Overland, MO 63114 | 2007-02-14 |
| Find all providers in zip 63114 | ||||
| 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 |
|---|---|---|---|---|
| 1609475516 | Brandi Janelle Hickman | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8706 Newton Ave Apt 4101, Kansas City, MO 64138-5461 | 2020-10-21 |
| 1154935112 | Overcomers Counseling Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17101 East 203rd St, Peculiar, MO 64078 | 2020-09-06 |
| 1386265965 | Candace Palmer | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2405 Bowe Ln, Jefferson City, MO 65109-9116 | 2020-05-05 |
| 1902426596 | Matt Ferguson | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4480 Bradley Dr, Joplin, MO 64804-5503 | 2020-04-23 |
| 1689206211 | Insight Industry LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2501 Ne Prairie Falcon Dr, Blue Springs, MO 64014-1958 | 2020-02-11 |
| 1598306904 | Hearo Technologies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 | 2019-10-07 |
| 1437790219 | Darin Roark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2628 Se Kimbrough Ln, Lees Summit, MO 64063-1082 | 2019-10-03 |
| 1942851399 | Wyatt's Dream Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 205 State Highway Aa, Sikeston, MO 63801-5303 | 2019-09-26 |
| 1043871908 | Cura Personalis, (care for The Whole Person), LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11650 Bobwhite Road, Carthage, MO 64836 | 2019-06-21 |
| 1043870181 | Rebuild Contracting LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1783 Possum Hollow Dr, Camdenton, MO 65020-6709 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
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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.