=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881728640
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILLER COUNTY BOARD FOR SERVICES FOR THE DEVELOPMENTALLY DISABLED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/15/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3771 HWY D
-----------------------------------------------------
City | LAKE OZARK
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65049-2290
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-348-3751
-----------------------------------------------------
Fax | 573-348-4065
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3771 HWY D
-----------------------------------------------------
City | LAKE OZARK
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65049-2290
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-348-3751
-----------------------------------------------------
Fax | 573-348-4065
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF SPECIAL SERVICES
-----------------------------------------------------
Name | MRS. KARLA YEARY LENT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 573-348-3751
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number | 1529-8593
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 320900000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
-----------------------------------------------------
License Number | 1529-8593
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------