CREATIVE PATHWAYS RESIDENTIAL SUPPORTS (NPI# 1962875815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962875815 |
| Entity Type | Organization |
| Organization Name | CREATIVE PATHWAYS RESIDENTIAL SUPPORTS |
| Practice Address |
331 E Clayton St Brookfield MO 64628-2215 |
| Practice Telephone | 6607340722 |
| Enumeration Date | 2015-11-01 |
| Last Update Date | 2016-12-22 |
| Authorized Official Name | JOSHUA WAYNE BILLINGSLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6607340722 |
| 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 |
331 E CLAYTON ST |
| City | BROOKFIELD |
| State | MO |
| Zip Code | 64628-2215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548821747 | Shirley L Arnold | Nurse Practitioner | 624 West Lockling Avenue, Brookfield, MO 64628 | 2019-06-27 |
| 1861761611 | Kristen Marie Butterfield | Physical Therapist | 116 East Pratt, Brookfield, MO 64628 | 2011-12-23 |
| 1588933386 | Jacey Lynne Mohr | Physical Therapy Assistant | 116 E Pratt, Brookfield, MO 64628 | 2011-12-22 |
| 1497841902 | Thomas Ervin Pitts | Dentist | 121 E Brooks St, Brookfield, MO 64628 | 2006-10-04 |
| 1902909559 | Hutchinson Clinic Inc | Allergy & Immunology | 624 W Lockling Ave, Brookfield, MO 64628 | 2006-09-07 |
| 1447257373 | Minerva C Concepcion-rivera | Internal Medicine | 125 East Lockling Avenue, Brookfield, MO 64628 | 2005-07-07 |
| 1992702823 | Pepito C Rivera | Surgery | 130 East Lockling Avenue, Brookfield, MO 64628 | 2005-07-07 |
| 1104322866 | Rebecca Frieda Krc | Emergency Medicine | 130 E Lockling St, Brookfield, MO 64628 | 2018-04-02 |
| 1427251750 | General John J. Pershing Memorial Hospital | Dietitian, Registered | 130 E Lockling St, Brookfield, MO 64628 | 2007-06-06 |
| 1407874126 | General John J Pershing Memorial Hospital Association | Home Health | 130 E Lockling Ave, Brookfield, MO 64628-0408 | 2006-07-18 |
| Find all providers in zip 64628 | ||||
| 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 |
|---|---|---|---|---|
| 1588842389 | Ability Beyond Disabillity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5 Squire Ct, Brookfield, CT 06804-3727 | 2008-02-04 |
| 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 | ||||
| City | BROOKFIELD |
| Zip Code | 64628 |
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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.