GIBSON RECOVERY CENTER, INC. (NPI# 1679928501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679928501 |
| Entity Type | Organization |
| Organization Name | GIBSON RECOVERY CENTER, INC. |
| Practice Address |
340 S Broadview St Cape Girardeau MO 63703-5703 |
| Mailing Address |
Po Box 1267 Cape Girardeau MO 63702-1267 |
| Practice Telephone | 5733320416 |
| Mailing Telephone | 5733320416 |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |
| Authorized Official Name | MR. JOHN GARY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5733320416 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
3056-7335 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1184774275 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184774275 | Gibson Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 1112 Linden St, Cape Girardeau, MO 63703-7707 | 2007-01-11 |
| 1164719373 | Gibson Recovery Center, Inc. | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-07-08 |
| Street Address |
340 S BROADVIEW ST |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63703-5703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598909939 | Janice L Ruesler | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2009-04-29 |
| 1750886909 | Mechelle Abernathy | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-03-29 |
| 1659879096 | Tina Fuller | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-31 |
| 1386152973 | Brenda Gause | Registered Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-17 |
| 1669803540 | Center for Relationship Recovery and Counseling | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2013-12-03 |
| 1689941528 | Jody Petzoldt | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-11-21 |
| 1093097917 | Mary Ann Roberston | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-09-16 |
| 1164719373 | Gibson Recovery Center, Inc. | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-07-08 |
| 1316232069 | John Eugene Nimmo | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566102 | Christian Torres Diaz | Dentist | 3070 William Street, Cape Girardeau, MO 63703 | 2018-07-30 |
| 1457758153 | Broadway Ltc, LLC | Pharmacy | 37 Doctors Park Ste 7, Cape Girardeau, MO 63703 | 2014-11-24 |
| 1336562263 | Rachel Speer | Community Health Worker | 20 South Sprigg St, Cape Girardeau, MO 63703 | 2014-01-29 |
| 1245653120 | Mary Wilburn | Community Health Worker | 20 S Spigg, Cape Girardeau, MO 63703 | 2014-01-28 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1033481163 | J K Essmyer Medical Services LLC | Clinic/Center | 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 | 2012-02-06 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1144413568 | Stephanie Danette Miller | Family Medicine | 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 | 2007-08-20 |
| 1437349305 | Shanaree Mae Muzinich | Radiology | 70 Doctor's Park, Cape Girardeau, MO 63703 | 2007-07-27 |
| Find all providers in zip 63703 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417302795 | Community Counseling Center | Clinic/Center | 402 S Silver Springs Rd, Cape Girardeau, MO 63703-7536 | 2016-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487179057 | Gateway Foundation, Inc. | Clinic/Center | 1430 Olive St Ste 300, Saint Louis, MO 63103-2303 | 2017-08-04 |
| 1700233145 | New Beginnings C-star | Clinic/Center | 1408 N Kingshighway Blvd Ste 4, Saint Louis, MO 63113-1426 | 2016-05-16 |
| 1629432182 | Clark Community Mental Health Center | Clinic/Center | 1701 N Central Ave, Monett, MO 65708 | 2016-04-11 |
| 1083024061 | Avertest, LLC | Clinic/Center | 4709 Laguardia Dr, Suite 100, Saint Louis, MO 63134 | 2014-04-30 |
| 1659718609 | Hannibal Council On Alcohol & Drug Abuse | Clinic/Center | 146 Communication Dr, Hannibal, MO 63401-3672 | 2013-05-31 |
| 1194026765 | Family Counseling Center, Inc. | Clinic/Center | 500 Us Hwy 61 North, Hayti, MO 63851 | 2010-11-12 |
| 1942501143 | Swope Health Services | Clinic/Center | 3950 E 51st St, Kansas City, MO 64130-3081 | 2010-11-04 |
| 1750682043 | Black Alcohol/drug Service Information Center | Clinic/Center | 3026 Locust St, Saint Louis, MO 63103-1329 | 2010-11-03 |
| 1932412186 | Comprehensive Mental Health Services, Inc/renaisance West | Clinic/Center | 5840 Swope Pkwy, Kansas City, MO 64130-4262 | 2010-07-16 |
| 1609194448 | Southeast Missouri Behavioral Health | Clinic/Center | 216 Piedmont Ave Ste 304, Piedmont, MO 63957-1017 | 2010-05-04 |
| Find all providers with the same taxonomy | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63703 |
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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.