BOARD OF EXPANDED SERVICES (NPI# 1679602049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679602049 |
| Entity Type | Organization |
| Organization Name | BOARD OF EXPANDED SERVICES |
| Other Organization Name | FIVE ACRES GROUP HOME |
| Practice Address |
1410 N Main St Carrollton MO 64633-1933 |
| Mailing Address |
Po Box 455 Carrollton MO 64633-0455 |
| Practice Telephone | 6605421401 |
| Mailing Telephone | 6605421401 |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2015-10-06 |
| Authorized Official Name | RUTH A THURLO (EXECUTIVE SECRETARY) |
| Authorized Official Telephone | 6605421401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 852991900 | MO | Residential Treatment Facilities |
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 852991900 | MO | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 852991900 | 05 |
| Other Name | Type Code |
|---|---|
| FIVE ACRES GROUP HOME | Doing Business As Name - Organization |
| Street Address |
1410 N MAIN ST |
| City | CARROLLTON |
| State | MO |
| Zip Code | 64633-1933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295140572 | B-pharm, Inc | Pharmacy | 1003 Highway 65 North, Suite B, Carrollton, MO 64633 | 2014-06-25 |
| 1023252541 | Pamela Lynn Ralls | Family Medicine | 1502 N.jefferson Street, Ccmh Medical Plaza, Carrollton, MO 64633 | 2009-04-28 |
| 1578733648 | Sloan Eyecare Center L.l.c | Optometrist | 1405 N Jefferson, Carroll County Jefferson Medical Pavillion, Carrollton, MO 64633 | 2008-03-05 |
| 1679616742 | Arlene Capistrano Germann | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-15 |
| 1932110483 | Tori D Waggoner | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2006-08-10 |
| 1376553511 | Gay Lynn Korff | Pharmacist | 1003 Hwy. 65, Carrollton, MO 64633 | 2006-08-09 |
| 1790730182 | Missouri Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1003 N Us Highway 65, Carrollton, MO 64633 | 2006-05-23 |
| 1700253812 | Jonna Hickcox Rechterman | Nurse Practitioner | 1502 N Jefferson St, Carrollton, MO 64633 | 2015-08-24 |
| 1790097764 | Jodi Dawn Ahnefeld | Pharmacist | 1003 Hwy 65 North, Carrollton, MO 64633 | 2010-07-07 |
| 1770618274 | James Mitchell Germann | Day Training/Habilitation Specialist | 1102 Lakeview Ct, Carrollton, MO 64633 | 2007-02-23 |
| Find all providers in zip 64633 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174691927 | St. John's Villa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Crest St Nw, Carrollton, OH 44615-8425 | 2006-12-01 |
| 1598827537 | Pathways Center for Behavioral & Developmental Growth | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 153 Independence Dr, Carrollton, GA 30116-9000 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578189742 | English Haven Support Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12578 Fee Fee Rd, Saint Louis, MO 63146-3863 | 2020-06-23 |
| 1427687441 | Nothing Like Home Health Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1024, Springfield, MO 65806-1110 | 2020-04-02 |
| 1669030086 | Cheree L Corderman | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1606 S 38th St, Saint Joseph, MO 64507-2216 | 2019-05-31 |
| 1306400973 | Boyer Aba Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22734 Pioneer Ln, Marshall, MO 65340-4744 | 2019-04-29 |
| 1861954661 | La Bella Vita, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9400 S Smith Hatchery Rd, Columbia, MO 65203-8965 | 2019-04-02 |
| 1104305127 | Shanonn Barr | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2007 S Harlem Ave, Joplin, MO 64804-0336 | 2018-08-09 |
| 1922501766 | Loria Faye Butler | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4518 Cypress Ave, Kansas City, MO 64130-2164 | 2018-03-16 |
| 1447760863 | Parity Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1027 S Main St Ste 301, Joplin, MO 64801-4500 | 2017-10-11 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1922526417 | Hard Knocks LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3381 1st St, Doe Run, MO 63637-3155 | 2017-09-05 |
| Find all providers with the same taxonomy | ||||
| City | CARROLLTON |
| Zip Code | 64633 |
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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.