Renville County Community Residence, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

802115 Issued in MN

Legal business name

RENVILLE COUNTY COMMUNITY RESIDENCE, INC.

Practice address

831 Grove Ave
Bird Island, MN 55310-1174

Phone

(320) 365-3748

NPI assigned

Apr 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Beverly Burman

Title

Executive Director

Phone

(320) 365-3748

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215150867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 GROVE AVE",
            "address_2": "P.O.BOX 520",
            "city": "BIRD ISLAND",
            "state": "MN",
            "postal_code": "553101174",
            "telephone_number": "320-365-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 GROVE AVE",
            "city": "BIRD ISLAND",
            "state": "MN",
            "postal_code": "553101174",
            "telephone_number": "320-365-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENVILLE COUNTY COMMUNITY RESIDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURMAN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "320-365-3748",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "802115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Bird Island, MN
• Providers in Bird Island, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.