PINE LODGE RESIDENTIAL CARE
NPI 1124275482
Assisted Living Facility in Buffalo, MO
About Pine Lodge Residential Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PINE LODGE RESIDENTIAL CARE (NPI 1124275482) is a healthcare organization registered as an assisted living facility in Buffalo, Missouri and active in the NPI registry since August 2008. The organization holds a CLIA Waiver certificate valid through April 13, 2028 and lists Pauline S Gunter, Owner/operator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 26D1082574
Pine Lodge Residential Care · Buffalo, MOFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Premier Residential Care LLC's NPI number?
The NPI number for Premier Residential Care LLC is 1124275482. It was assigned to this organization in the NPPES registry on August 19, 2008. The provider is doing business as Pine Lodge Residential Care.
Where is Premier Residential Care LLC located?
Premier Residential Care LLC is located at 967 North Maple, Buffalo, MO 65622. The listed phone number is (417) 345-0310.
What is Premier Residential Care LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Premier Residential Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 26D1082574) is associated with this NPI, valid through April 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Premier Residential Care LLC was last updated on August 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Pine Lodge Residential Care · NPI 1124275482
Assisted Living Facility organization in Buffalo, Missouri. Organization record, active in the CMS NPPES registry since August 19, 2008.
## Identity
- **NPI:** 1124275482 (Entity type: Organization)
- **Enumerated:** August 19, 2008
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** Premier Residential Care Llc
- **Organization subpart:** No
- **Authorized official:** Pauline Gunter, OWNER/OPERATOR
## Practice location
- **Address:** 967 NORTH MAPLE, Buffalo, MO 65622
- **Phone:** (417) 345-0310
## Record status
- **NPPES last updated:** August 19, 2008
- **Other identifiers:** Medicaid 1891979126 (MO)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1124275482) · Data from the CMS NPPES public registry.