Healthcare Provider Details

I. General information

NPI: 1336264340
Provider Name (Legal Business Name): SKILLS UNLIMITED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 W HUNTER ST
NEVADA MO
64772-2327
US

IV. Provider business mailing address

114 W HUNTER ST
NEVADA MO
64772-2327
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-6021
  • Fax:
Mailing address:
  • Phone: 417-667-6021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1970-9161
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number1970-9161
License Number StateMO

VIII. Authorized Official

Name: DOUG NICKELSON
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 417-667-6021