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AMBROSE PARK RESIDENTIAL CARE FACILITY
NPI 1962633818
Assisted Living Facility in Cole Camp, MO

Active since July 27, 2009CLIA 26D2033703 · Waiver
517 NORTH OAK STREET, COLE CAMP, MO 65325(660) 668-3140(660) 668-0108 Get Directions Write a Review

NPPES record last updated: July 30, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ambrose Park Residential Care Facility NPPES

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

AMBROSE PARK RESIDENTIAL CARE FACILITY (NPI 1962633818) is a healthcare organization registered as an assisted living facility in Cole Camp, Missouri and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through December 7, 2027 and lists Rexanna Kay Kreisel, Owner, as its authorized official.

NPPES Registry Identity

NPI1962633818
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameAMBROSE PARK RESIDENTIAL CARE FACILITY
Location Address517 NORTH OAK STREETCole Camp, MO 65325
Mailing AddressPo Box 252Cole Camp, MO 65325-0252 · (660) 668-3140 · Fax (660) 668-0108
Phone(660) 668-3140
Fax(660) 668-0108
Organization SubpartNo
Authorized OfficialRexanna Kay KreiselOwner · (660) 668-3140
Enumeration DateJuly 27, 2009
Last NPPES UpdateJuly 30, 2009
✔ NPI 1962633818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 037166
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.
517 NORTH OAK STREET, Cole Camp, MO 65325
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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 26D2033703

Ambrose Park Residential Care Facility · Cole Camp, MO
Active · expires Dec 7, 2027
CLIA Number26D2033703
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 8, 2025
Certificate Expiration DateDecember 7, 2027
Laboratory DirectorRexanna Kreisel
Laboratory Phone(660) 668-3140
Laboratory LocationAmbrose Park Residential Care Facility517 North Oak Street, Cole Camp, MO 65325
CLIA data matches this NPI record on: Address Name Phone
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 Ambrose Park Residential Care Facility's NPI number?

The NPI number for Ambrose Park Residential Care Facility is 1962633818. It was assigned to this organization in the NPPES registry on July 27, 2009.

Where is Ambrose Park Residential Care Facility located?

Ambrose Park Residential Care Facility is located at 517 North Oak Street, Cole Camp, MO 65325. The listed phone number is (660) 668-3140.

What is Ambrose Park Residential Care Facility's specialty?

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

Does Ambrose Park Residential Care Facility hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2033703) is associated with this NPI, valid through December 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ambrose Park Residential Care Facility was last updated on July 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.