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

NPI Status: Active since July 27, 2009

Contact Information

517 NORTH OAK STREET
COLE CAMP, MO
ZIP 65325
Phone: (660) 668-3140
Fax: (660) 668-0108

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 26D2033703
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 12-07-2027

About AMBROSE PARK RESIDENTIAL CARE FACILITY

This page provides the complete NPI Profile along with additional information for Ambrose Park Residential Care Facility, a provider established in Cole Camp, Missouri operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1962633818 assigned on July 2009. The practitioner's primary taxonomy code is 310400000X with license number 037166 (MO). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Mrs. Rexanna Kay Kreisel R.n. (Owner)

NPI
1962633818
Provider Name
AMBROSE PARK RESIDENTIAL CARE FACILITY
Entity Type
Organization
Location Address
517 NORTH OAK STREET COLE CAMP, MO 65325
Location Phone
(660) 668-3140
Location Fax
(660) 668-0108
Mailing Address
PO BOX 252 COLE CAMP, MO 65325
Mailing Phone
(660) 668-3140
Mailing Fax
(660) 668-0108
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-27-2009
Last Update Date
07-30-2009
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
037166
License State
MO
Taxonomy Description
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.

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

MRS. REXANNA KAY KREISEL R.N.

Authorized Official Title
OWNER
Authorized Official Phone
(660) 668-3140

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
26D2033703
Facility Type
Assisted Living Facility
Certificate Effective Date
December 08, 2025
Certificate Expiration Date
December 07, 2027
Laboratory Director
REXANNA KREISEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Ambrose Park Residential Care Facility 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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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1962633818, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
2
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
3
Unchanged
Pos 7
3
Doubled → 6
Pos 8
8
Unchanged
Pos 9
1
Doubled → 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 3 → 6 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 2 + 2 + 1 + 2 + 3 + 6 + 8 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1962633818.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962633818, enumerated as an "organization" on July 27, 2009.

The provider is located at 517 NORTH OAK STREET COLE CAMP, MO 65325 and the phone number is (660) 668-3140.

Assisted Living Facility with taxonomy code 310400000X.