LICKING RESIDENTIAL CARE
NPI 1275530776
Custodial Care Facility - Adult Care Home in Licking, MO

NPI Status: Active since June 30, 2005

Contact Information

225 W HIGHWAY 32
LICKING, MO
ZIP 65542
Phone: (573) 674-2207
Fax: (573) 674-2239

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  • Organization
  • Custodial Care Facility
  • Adult Care Home
  • CLIA Number: 26D1038551
  • CLIA Cert. Type: Other - RCF II
  • CLIA Exp. Date: 03-21-2027

About LICKING RESIDENTIAL CARE

This page provides the complete NPI Profile along with additional information for Licking Residential Care, a provider established in Licking, Missouri operating as a Custodial Care Facility, focusing in adult care home . The healthcare provider is registered in the NPI registry with number 1275530776 assigned on June 2005. The practitioner's primary taxonomy code is 311ZA0620X with license number 030734 (MO). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Licking Residential Care. The authorized official of this NPI record is James Giardina (President)

NPI
1275530776
Provider Legal Name
COMMUNITY RESIDENCE, INC.
Other Organization Name
LICKING RESIDENTIAL CARE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
225 W HIGHWAY 32 LICKING, MO 65542
Location Phone
(573) 674-2207
Location Fax
(573) 674-2239
Mailing Address
312 SOLLEY DR REAR BALLWIN, MO 63021
Mailing Phone
(636) 394-3000
Mailing Fax
(573) 674-2239
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
06-30-2005
Last Update Date
06-13-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Custodial Care Facility Adult Care Home

Taxonomy Code
311ZA0620X
Type
Nursing & Custodial Care Facilities
License No.
030734
License State
MO
Taxonomy Description
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JAMES GIARDINA

Authorized Official Title
PRESIDENT
Authorized Official Phone
(636) 394-3000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
266178706MEDICAID (05)MO 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D1038551
Facility Type
Other - RCF II
Certificate Effective Date
March 22, 2025
Certificate Expiration Date
March 21, 2027
Laboratory Director
RHONDA OVERBY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Licking Residential Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1275530776, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
5
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
3
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 0 → 0 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 4 + 5 + 1 + 0 + 3 + 0 + 7 + 1 + 4 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1275530776.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Assisted Living Facility
225 W HIGHWAY 32
LICKING, MO 65542

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275530776, enumerated as an "organization" on June 30, 2005.

The provider is located at 225 W HIGHWAY 32 LICKING, MO 65542 and the phone number is (573) 674-2207.

Custodial Care Facility with taxonomy code 311ZA0620X and a focus in Adult Care Home.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.