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GRACIE LANE DAY HAB, LLC
NPI 1881055812
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Koshkonong, MO

Active since March 18, 2016
RR 81 BOX 175, KOSHKONONG, MO 65692(417) 867-3397(417) 867-3367 Get Directions Write a Review

NPPES record last updated: March 22, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 22, 2016, Mar 18, 2016 (2 updates tracked since 2016).

About Gracie Lane Day Hab, Llc NPPES

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

GRACIE LANE DAY HAB, LLC (NPI 1881055812) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Koshkonong, Missouri and active in the NPI registry since March 2016. The organization lists Myrtle E Rigel, Owner/administrator, as its authorized official.

NPPES Registry Identity

NPI1881055812
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameGRACIE LANE DAY HAB, LLC
Location AddressRR 81 BOX 175Koshkonong, MO 65692-8004
Mailing AddressRr 81 Box 175Koshkonong, MO 65692-8004 · (417) 867-3397
Phone(417) 867-3397
Fax(417) 867-3367
Organization SubpartNo
Authorized OfficialMyrtle E RigelOwner/administrator · (417) 867-3397
Enumeration DateMarch 18, 2016
Last NPPES UpdateMarch 22, 20162 updates tracked since enumeration
✔ NPI 1881055812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in MO · CC03100514
Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Also ListedRespite CareTaxonomy 385H00000X · License CC03100514 (MO)
RR 81 BOX 175, Koshkonong, MO 65692
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Other Identifiers 1

Medicaid856321104MO

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 Gracie Lane Day Hab, LLC's NPI number?

The NPI number for Gracie Lane Day Hab, LLC is 1881055812. It was assigned to this organization in the NPPES registry on March 18, 2016.

Where is Gracie Lane Day Hab, LLC located?

Gracie Lane Day Hab, LLC is located at Rr 81 Box 175, Koshkonong, MO 65692. The listed phone number is (417) 867-3397.

What is Gracie Lane Day Hab, 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 Gracie Lane Day Hab, LLC was last updated on March 22, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.