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WILLOW CREEK GROUP HOME SOUTH
NPI 1871897017
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Adrian, MO

Active since January 03, 2011
1008 EDITH AVE., ADRIAN, MO 64720(816) 225-8214(816) 297-8956 Get Directions Write a Review

NPPES record last updated: January 28, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Willow Creek Group Home South NPPES

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

WILLOW CREEK GROUP HOME SOUTH (NPI 1871897017) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Adrian, Missouri and active in the NPI registry since January 2011. The organization lists Christian Dennison, Owner, as its authorized official.

NPPES Registry Identity

NPI1871897017
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameWILLOW CREEK ISL, LLC
Location Address1008 EDITH AVE.Adrian, MO 64720
Mailing Address1008 Edith Ave.Adrian, MO 64720 · (816) 225-8214 · Fax (816) 297-8956
Phone(816) 225-8214
Fax(816) 297-8956
Organization SubpartNo
Authorized OfficialChristian DennisonOwner · (816) 225-8214
Enumeration DateJanuary 3, 2011
Last NPPES UpdateJanuary 28, 2022
NPPES CertifiedJanuary 28, 2022
✔ NPI 1871897017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in MO · 134112203
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
1008 EDITH AVE., Adrian, MO 64720
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Other Names 1

Other NameWillow Creek Group Home South

Other Providers at the Same Location NPPES

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

WILLOW CREEK ISL, LLC
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1008 EDITH AVE.
ADRIAN, MO 64720
Bates County (816) 225-8214

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 Willow Creek Isl, LLC's NPI number?

The NPI number for Willow Creek Isl, LLC is 1871897017. It was assigned to this organization in the NPPES registry on January 3, 2011. The provider is also known as Willow Creek Group Home South.

Where is Willow Creek Isl, LLC located?

Willow Creek Isl, LLC is located at 1008 Edith Ave., Adrian, MO 64720. The listed phone number is (816) 225-8214.

What is Willow Creek Isl, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Willow Creek Isl, LLC was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.