ANNA DODSON HOME LLC
NPI 1902369663
Community Based Residential Treatment Facility, Mental Illness in Farmington, MO

Active since April 10, 2019CLIA 26D0922337 · Waiver
4616 HWY D, FARMINGTON, MO 63640(573) 756-5530(573) 756-5530 Get Directions Write a Review

NPPES record last updated: April 10, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Community Based Residential Treatment Fa...
  • CLIA Number: 26D0922337
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 11-20-2026

About ANNA DODSON HOME LLC

This page provides the complete NPI Profile along with additional information for Anna Dodson Home Llc, a provider established in Farmington, Missouri operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1902369663 assigned on April 2019. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Penny Mcdowell (Main Member/administrator)

NPI
1902369663 Verify this NPI
Provider Name
ANNA DODSON HOME LLC
Entity Type
Organization
Location Address
4616 HWY D FARMINGTON, MO 63640
Location Phone
(573) 756-5530
Location Fax
(573) 756-5530
Mailing Address
4616 HWY D FARMINGTON, MO 63640
Mailing Phone
(573) 756-5530
Mailing Fax
(573) 756-5530
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-10-2019
Last Update Date
04-10-2019
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community Based Residential Treatment Facility, Mental Illness

Taxonomy Code
320800000X
Type
Residential Treatment Facilities
Taxonomy Description
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

PENNY MCDOWELL

Authorized Official Title
MAIN MEMBER/ADMINISTRATOR
Authorized Official Phone
(573) 631-3644

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D0922337
Facility Type
Other
Certificate Effective Date
November 21, 2024
Certificate Expiration Date
November 20, 2026
Laboratory Director
PENNY R. MCDOWELL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Anna Dodson Home Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902369663, enumerated as an "organization" on April 10, 2019.

The provider is located at 4616 HWY D FARMINGTON, MO 63640 and the phone number is (573) 756-5530.

Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.