WILLOW CREEK ISL, LLC — NPI 1871897017 (Licensed & Credentialed Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in ADRIAN, MO)

CMS-1500 Box 24J / 33a • NPI

1871897017

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

320900000X

Licensed & Credentialed Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Box 32 Service Location & ZIP+4

1008 EDITH AVE., ADRIAN, MO, 64720

Official NPPES Practice Location

Practice Phone & Referral Fax

(816) 225-8214

Fax: (816) 297-8956

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1871897017 (WILLOW CREEK ISL, LLC) 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

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1871897017` (NPI-2 Organization / Facility)
Provider / Legal Name	WILLOW CREEK ISL, LLC
Plain-English Specialty	Licensed & Credentialed Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities NUCC Code: `320900000X` (Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1008 EDITH AVE., ADRIAN, MO, 64720
Practice Telephone / Fax	Tel: (816) 225-8214 \| Fax: (816) 297-8956
Administrative Mailing Address	1008 EDITH AVE., ADRIAN, MO, 64720
Enumeration & Last Sync	Enumerated: 2011-01-03 \| CMS Record Updated: 2022-01-28
Authorized Official	CHRISTIAN DENNISON (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1008 EDITH AVE., ADRIAN, MO, 64720

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Plain-English Taxonomy & CMS Crosswalk (320900000X)

What Does Taxonomy Code 320900000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 320900000X translates to:
"Licensed & Credentialed Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (WILLOW CREEK ISL, LLC)

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

Common Therapeutic Classes:

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
`320900000X` — Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities Plain English: Licensed & Credentialed Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	State: MO \| License: `134112203` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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WILLOW CREEK ISL, LLC (NPI #1871897017)