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NPI 1043160799

NPI 1043160799 : RIPLEY COUNTY PRODUCTIVE LIVING BOARD : DONIPHAN, MO

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General NPI Number Information
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    NPI Number           |    1043160799
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    Entity Type          |    Organization 
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    Legal Business Name  |    RIPLEY COUNTY PRODUCTIVE LIVING BOARD 
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Dates
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    Enumeration Date     |    02/02/2026
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    Last Update Date     |    02/04/2026
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Provider Practice Location Address
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    Address Line         |    244 E HIGHWAY ST 
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    City                 |    DONIPHAN
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    State                |    MO
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    Zip                  |    63935-1021
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    Country              |    US
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    Telephone            |    573-827-4977
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    244 E HIGHWAY ST 
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    City                 |    DONIPHAN
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    State                |    MO
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    Zip                  |    63935-1021
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    Country              |    US
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    Telephone            |    573-827-4977
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     JESSICA  WILKERSON 
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    Credential           |    
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    Telephone            |    417-540-8959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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