Life Enhancement Village in Nixa - Assisted Living, Mental Illness
Life Enhancement Village - NPI 1538338652
Life Enhancement Village is a Assisted Living, Mental Illness in Nixa, Missouri. Life Enhancement Village practices all healthcare services and medical treatments related to Assisted Living, Mental Illness. The NPI Number for Life Enhancement Village is 1538338652. The last update date is 2008-02-22.
Life Enhancement Village's current location address is 732 S Gregg Rd, Nixa, Missouri. You can contact this provider via phone number 4177256671 and fax number 4177256671. The mailing address for Life Enhancement Village is 732 S Gregg Rd, Nixa, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Life Enhancement Village |
|---|---|
| Address | 732 S Gregg Rd, Nixa, Missouri |
| Phone Number | 4177256671 |
| Fax Number | 4177256671 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Rogers L Kenny |
| Telephone Number | 4177256680 |
NPI Number Detail
| NPI Number | 1538338652 |
|---|---|
| Provider Enumeration Date | 2008-02-22 |
| Last Updated Date | 2008-02-22 |
Provider Mailing Address Detail
| Address | 732 S Gregg Rd |
|---|---|
| City | Nixa |
| State | Missouri (MO) |
| Post Code | 657147419 |
| Phone Number | 4177256671 |
| Fax Number | 4177256671 |
Provider's Primary Taxonomy Detail
| Speciality | Assisted Living, Mental Illness |
|---|---|
| Taxonomy | 3104A0625X |
| Licence No | 32542 |
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Definition: A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff w |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3751109 | MO | -- |
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What is the Life Enhancement Village's unique identification number?
The Life Enhancement Village has been assigned the NPI (National Provider Identifier) Number 1538338652 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Life Enhancement Village located?
The Life Enhancement Village is located at 732 S Gregg Rd, Nixa, MO 657147419.
What is Life Enhancement Village's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Life Enhancement Village is Assisted Living, Mental Illness, and the taxonomy code that classifies this field of practice is 3104A0625X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1538338652 to Life Enhancement Village?
The Centers for Medicare & Medicaid Services originally issued the 1538338652 to Life Enhancement Village on 2008-02-22.
As of what date were the Life Enhancement Village's details last updated?
The information pertaining to the Life Enhancement Village, including its address, specialty, and other details, was most recently updated on 2008-02-22.
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