PEACHWOOD MANOR, LLC (NPI# 1710517701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710517701 |
| Entity Type | Organization |
| Organization Name | PEACHWOOD MANOR, LLC |
| Practice Address |
15895 State Highway 76 Cassville MO 65625-8098 |
| Practice Telephone | 4178473902 |
| Practice Fax Number | 4178470522 |
| Mailing Telephone | 4178473902 |
| Mailing Fax Number | 4178470522 |
| Enumeration Date | 2020-01-19 |
| Last Update Date | 2020-01-19 |
| Authorized Official Name | LYNDA DACY (OWNER/MANAGER) |
| Authorized Official Telephone | 4178466050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| PEACHWOOD MANOR | Doing Business As Name - Organization |
| Street Address |
15895 STATE HIGHWAY 76 |
| City | CASSVILLE |
| State | MO |
| Zip Code | 65625-8098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568877231 | Angela Conklin | Family Medicine | 75 Smithson Dr Ste A, Cassville, MO 65625 | 2014-06-21 |
| 1548394166 | Peach Wood Manor Rcf | Custodial Care Facility | Highway 12, Cassville, MO 65625 | 2007-03-15 |
| 1861534299 | John Carl Ruetschi | Dentist | Rt #1 Box 1714, Southwest Family Dentistry, Cassville, MO 65625 | 2007-02-13 |
| 1447353602 | Stephen Joseph Mebruer | Optometrist | 10340 Farm Rd. 2176, Cassville, MO 65625 | 2006-09-06 |
| 1205886769 | Ozark Tri County Health Care Consortium | Clinic/Center | 4016 N Main Street, Cassville, MO 65625 | 2006-05-12 |
| 1205806635 | Steven Kent Runnels | Chiropractor | 101-2 S. Main St., Cassville, MO 65625 | 2006-01-26 |
| 1437639036 | Regional Services | Nurse Practitioner | 1501 Main St, Cassville, MO 65625 | 2018-08-14 |
| 1710472444 | Kasey King | Nurse Practitioner | 94 Main St, Cassville, MO 65625 | 2018-06-26 |
| 1528307493 | Rita Logan Seger | Internal Medicine | 92 Main St, Cassville, MO 65625 | 2013-02-12 |
| 1144554171 | Stephen J. Mebruer, O.d., L.L.C. | Optometrist | 10340 Farm Rd. 2176, Cassville, MO 65625 | 2009-09-23 |
| Find all providers in zip 65625 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750562377 | M & R Long, Inc | Assisted Living Facility | 71 Sycamore St, Cassville, MO 65625-1755 | 2007-11-26 |
| 1255736518 | Cedar Ridge Care Center, LLC | Assisted Living Facility | 71 Sycamore St, Cassville, MO 65625-1755 | 2014-10-29 |
| 1295141760 | Mary Howlett | Assisted Living Facility | 71 Sycamore St, Cassville, MO 65625-1755 | 2014-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820283 | Oak Meadows Rcf LLC | Assisted Living Facility | 5502 Misty Meadow Rd, Poplar Bluff, MO 63901-9287 | 2020-10-28 |
| 1700486859 | Hillcrest Residential Care | Assisted Living Facility | 9415 N North Browns Station Rd, Columbia, MO 65202-8671 | 2020-10-28 |
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1205433638 | Skyline Assisted Living LLC | Assisted Living Facility | 100 Hard Rock Rd, Van Buren, MO 63965-0780 | 2020-10-08 |
| 1023615622 | Four Seasons Care Corp | Assisted Living Facility | 230 Railroad St, Moscow Mills, MO 63362-1600 | 2020-10-06 |
| 1336754985 | Tiffany Springs Senior Care Community | Assisted Living Facility | 9101 N Ambassador Dr, Kansas City, MO 64154-7295 | 2020-09-10 |
| 1366053480 | Green Acres Assisted Living LLC | Assisted Living Facility | 411 N Kings Highway, Sikeston, MO 63801-1936 | 2020-08-12 |
| 1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
| 1831725142 | Harmony Gardens Residential, LLC | Assisted Living Facility | 539 E Young Ave, Warrensburg, MO 64093-1228 | 2020-03-18 |
| 1386278414 | Family Partners Home LLC | Assisted Living Facility | 232 Creve Coeur Ave, Manchester, MO 63011-4040 | 2020-02-27 |
| 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.