CMS-1500 Box 24J / 33a • NPI
1285398024
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3104A0625X
Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness
Box 32 Service Location & ZIP+4
81 PILKENTON LN, CUBA, MO, 65453-8136
✓ 9-Digit EDI 837 ZIP+4 (65453-8136)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1285398024 (EQUILIBRIUM RANCH) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1285398024 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | EQUILIBRIUM RANCH |
| Plain-English Specialty | Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness NUCC Code: 3104A0625X (Assisted Living Facility, Assisted Living, Mental Illness) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 81 PILKENTON LN, CUBA, MO, 65453-8136 |
| Practice Telephone / Fax | Tel: (573) 885-6443 | Fax: (844) 851-0578 |
| Administrative Mailing Address | 81 PILKENTON LN, CUBA, MO, 65453-8136 |
| Enumeration & Last Sync | Enumerated: 2021-10-27 | CMS Record Updated: 2025-01-03 |
| Authorized Official | CHRISTIAN SHELTON (Owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (3104A0625X)
What Does Taxonomy Code 3104A0625X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3104A0625X translates to:
"Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (EQUILIBRIUM RANCH)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
171M00000X — Case Manager/Care CoordinatorPlain English: Licensed & Credentialed Case Manager/Care Coordinator | State: N/A | License: Verified | Primary: Secondary |
251B00000X — Case ManagementPlain English: Licensed & Credentialed Case Management | State: N/A | License: Verified | Primary: Secondary |
3104A0625X — Assisted Living Facility, Assisted Living, Mental IllnessPlain English: Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness | State: N/A | License: Verified | Primary: Yes (Primary) |
311ZA0620X — Custodial Care Facility, Adult Care HomePlain English: Licensed & Credentialed Custodial Care Facility, Adult Care Home | State: N/A | License: Verified | Primary: Secondary |
364SL0600X — Clinical Nurse Specialist, Long-Term CarePlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Long-term Care | State: N/A | License: Verified | Primary: Secondary |
3747P1801X — Technician, Personal Care AttendantPlain English: Licensed & Credentialed Technician, Personal Care Attendant | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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