PULASKI COUNTY GROUP HOME – NPI #1356462022
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

PULASKI COUNTY GROUP HOME is a community based residential treatment facility located in CROCKER, MO. NPPES has assigned the NPI number 1356462022 to PULASKI COUNTY GROUP HOME on April 02, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 16 years ago on Feb 17, 2010. 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 PULASKI COUNTY GROUP HOME below.

NPI Profile for
PULASKI COUNTY GROUP HOME

NPI Number
1356462022
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
PULASKI COUNTY GROUP HOME
Primary location
307 KEETH ROAD
CROCKER, MO 65452
Phone: (573) 736-5603 Fax: (573) 736-2771
Mailing address
PO BOX 662
CROCKER, MO 65452-0662
Phone: (573) 736-5603 Fax: (573) 736-2771
Organization Subpart
No
Authorized Official
BOBBIE MORRIS
ADMINISTRATOR
Phone: (573) 736-5603
Updated
Identifiers

Identifiers for PULASKI COUNTY GROUP HOME

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
MEDICAIDMO853890804
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.

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.