1. Home
  2. Directory
  3. Missouri
  4. Urbana
  5. Custodial Care Facility
  6. NPI Profile
  7. NPI Record 1730836701

URBANA GROUP HOME
Complete NPI Record 1730836701
Custodial Care Facility in Urbana, MO

NPI Status: Active since March 09, 2022

Contact Information

310 WALNUT ST
URBANA, MO
ZIP 65767
Phone: (417) 733-4162

Get Directions

Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Middle Name
  24. Authorized Official Title or Position
  25. Authorized Official Telephone Number
  26. Healthcare Provider Taxonomy Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Other Provider Identifier 1
  29. Other Provider Identifier Type Code 1
  30. Other Provider Identifier State 1
  31. Is Organization Subpart
  32. Parent Organization LBN
  33. Parent Organization TIN
  34. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1730836701. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1730836701
The date the provider was assigned a unique identifier (assigned an NPI).
Entity Type Code: 2
The date that a record was last updated or changed.
Employer Identification Number EIN: UNAVAIL
The code designating the provider’s gender if the provider is a person.
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Other Organization Name: URBANA GROUP HOME
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 311 W BROADWAY ST
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: URBANA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MO
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 657679101
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8009935141
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 310 WALNUT ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: URBANA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MO
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 657679208
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4177334162
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 3/9/2022
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 5/18/2022
The date that a record was last updated or changed.
Authorized Official Last Name: HEFLIN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: KATIE
The first name of the authorized official.
Authorized Official Middle Name: P
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 8009935141
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 311Z00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 260003902
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: MO
Is Organization Subpart: Y
Parent Organization LBN: CHRISTIAN HOME CARE LLC
Parent Organization TIN: UNAVAIL
NPI Certification Date: 5/18/2022