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BROOKSIDE MANOR RESIDENTIAL CARE, LLC
NPI 1275713638
Assisted Living Facility in Farmington, MO

Active since November 13, 2007CLIA 26D2117374 · Waiver
2434 HIGHWAY H, FARMINGTON, MO 63640(573) 756-6434(573) 756-6434 Get Directions Write a Review

NPPES record last updated: November 13, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brookside Manor Residential Care, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKSIDE MANOR RESIDENTIAL CARE, LLC (NPI 1275713638) is a healthcare organization registered as an assisted living facility in Farmington, Missouri and active in the NPI registry since November 2007. The organization holds a CLIA Waiver certificate valid through August 15, 2026 and lists Starla Kay Dulworth, Administrator/owner, as its authorized official.

NPPES Registry Identity

NPI1275713638
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBROOKSIDE MANOR RESIDENTIAL CARE, LLC
Location Address2434 HIGHWAY HFarmington, MO 63640-7033
Mailing Address2434 Highway HFarmington, MO 63640-7033 · (573) 756-6434 · Fax (573) 756-6434
Phone(573) 756-6434
Fax(573) 756-6434
Organization SubpartNo
Authorized OfficialStarla Kay DulworthAdministrator/owner · (573) 756-6434
Enumeration DateNovember 13, 2007
✔ NPI 1275713638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 034901
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
2434 HIGHWAY H, Farmington, MO 63640
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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 26D2117374

Brookside Manor Residential Care LLC · Farmington, MO
Active · expires Aug 15, 2026
CLIA Number26D2117374
Laboratory TypeRcf
Certificate Effective DateAugust 16, 2024
Certificate Expiration DateAugust 15, 2026
Laboratory DirectorStarla Dulworth
Laboratory Phone(573) 756-6434
Laboratory LocationBrookside Manor Residential Care LLC2434 Hwy H, Farmington, MO 63640
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BROOKSIDE MANOR
Assisted Living Facility
2434 HIGHWAY H
FARMINGTON, MO 63640
St. Francois County (573) 756-6434

Frequently 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 Brookside Manor Residential Care, LLC's NPI number?

The NPI number for Brookside Manor Residential Care, LLC is 1275713638. It was assigned to this organization in the NPPES registry on November 13, 2007.

Where is Brookside Manor Residential Care, LLC located?

Brookside Manor Residential Care, LLC is located at 2434 Highway H, Farmington, MO 63640. The listed phone number is (573) 756-6434.

What is Brookside Manor Residential Care, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Brookside Manor Residential Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2117374) is associated with this NPI, valid through August 15, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Brookside Manor Residential Care, LLC was last updated on November 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.