SUPERIOR PARK – NPI #1295922458
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

SUPERIOR PARK is a community based residential treatment facility located in EXCELSIOR SPRINGS, MO. NPPES has assigned the NPI number 1295922458 to SUPERIOR PARK on October 01, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SUPERIOR PARK” is a dba name, the actual legal business name for this organization is DST INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 18 years ago on Jun 30, 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 SUPERIOR PARK below.

NPI Profile for
DST INC

NPI Number
1295922458
Enumeration Date

(more than 18 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
DST INC
Doing Business As (dba): SUPERIOR PARK
Primary location
410 SUPERIOR
EXCELSIOR SPRINGS, MO 64024
Phone: (816) 630-3177 Fax: (816) 630-6100
Mailing address
PO BOX 126
410 SUPERIOR
EXCELSIOR SPRINGS, MO 64024
Phone: (816) 630-3177 Fax: (816) 630-6100
Organization Subpart
No
Authorized Official
THOMAS WALKER
PRESIDENT DST INC & ADMINISTRATOR
Phone: (816) 630-3177
Updated
Identifiers

Identifiers for SUPERIOR PARK

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
MEDICAIDMO268002409
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
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
MO 035519
3104A0625X
- Assisted Living Facility / Assisted Living, Mental Illness
MO 033231

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.