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TEAL LAKE RESIDENTIAL, LLC
NPI 1568419117
Assisted Living Facility in Mexico, MO

Active since May 28, 2006CLIA 26D1034098 · Waiver
1722 HUNTINGFIELD DR, MEXICO, MO 65265(573) 582-7800 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 2, 2026, Aug 22, 2020 (2 updates tracked since 2020).

About Teal Lake Residential, Llc NPPES

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

TEAL LAKE RESIDENTIAL, LLC (NPI 1568419117), doing business as Teal Lake Assissted Living, is a healthcare organization registered as an assisted living facility in Mexico, Missouri and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through November 23, 2026 and lists Kyle Timothy Schade, Manager, as its authorized official.

NPPES Registry Identity

NPI1568419117
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameTEAL LAKE RESIDENTIAL, LLC
Location Address1722 HUNTINGFIELD DRMexico, MO 65265-3786
Mailing Address1722 Huntingfield DrMexico, MO 65265-3802 · (573) 582-7800
Phone(573) 582-7800
Organization SubpartNo
Authorized OfficialKyle Timothy SchadeManager · (573) 471-1113
Enumeration DateMay 28, 2006
Last NPPES UpdateFebruary 2, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1568419117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
1722 HUNTINGFIELD DR, Mexico, MO 65265
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Other Names 1

Doing Business AsTeal Lake Assissted Living

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 26D1034098

Teal Lake Alf · Mexico, MO
Active · expires Nov 23, 2026
CLIA Number26D1034098
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 24, 2024
Certificate Expiration DateNovember 23, 2026
Laboratory DirectorBetsy J. Sluhan
Laboratory Phone(573) 582-7822
Laboratory LocationTeal Lake Alf1722 Huntingfield Drive, Mexico, MO 65265
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

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 Teal Lake Residential, LLC's NPI number?

The NPI number for Teal Lake Residential, LLC is 1568419117. It was assigned to this organization in the NPPES registry on May 28, 2006. The provider is doing business as Teal Lake Assissted Living.

Where is Teal Lake Residential, LLC located?

Teal Lake Residential, LLC is located at 1722 Huntingfield Dr, Mexico, MO 65265. The listed phone number is (573) 582-7800.

What is Teal Lake Residential, LLC's specialty?

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

Does Teal Lake Residential, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D1034098) is associated with this NPI, valid through November 23, 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 Teal Lake Residential, LLC was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.