COUNTRY CLUB CARE CENTER – NPI #1356481907
Residential Treatment Facility, Physical Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

Health Care Provider Taxonomy Code for Residential Treatment Facility, Physical Disabilities

COUNTRY CLUB CARE CENTER is a residential treatment facility (RTF) located in WARRENSBURG, MO. NPPES has assigned the NPI number 1356481907 to COUNTRY CLUB CARE CENTER on February 06, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “COUNTRY CLUB CARE CENTER” is a dba name, the actual legal business name for this organization is COUNTRY CLUB CARE CENTER OF WARRENSBURG L C. The primary taxonomy selected by this provider is 320700000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Physical Disabilities.

The NPI profile was previously updated about 18 years ago on Jun 17, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COUNTRY CLUB CARE CENTER below.

NPI Profile for
COUNTRY CLUB CARE CENTER OF WARRENSBURG L C

NPI Number
1356481907
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COUNTRY CLUB CARE CENTER OF WARRENSBURG L C
Doing Business As (dba): COUNTRY CLUB CARE CENTER
Primary location
503 REGENT DR
WARRENSBURG, MO 64093-3231
Phone: (660) 429-4444 Fax: (660) 429-4331
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
STEVE BUNCH
VICE PRESIDENT OF OPERATIONS
Phone: (660) 429-4444
Updated
Identifiers

Identifiers for COUNTRY CLUB CARE CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMO268298007
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320700000X
- Residential Treatment Facility, Physical Disabilities (Primary)		 MO 035594

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.