Senior Palace Adult Care

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SENIOR PALACE ADULT CARE

Practice address

27815 S Stoney Island Ave
Crete, IL 60417-8001

Phone

(319) 651-8351

NPI assigned

Jul 26, 2023

Organization subpart

No

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

Authorized official

Name

Shannon R Jones

Title

Certified Adult Daycare Provider

Phone

(319) 651-8351

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1225719974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4734 JOHNSON AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463271530",
            "telephone_number": "319-651-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27815 S STONEY ISLAND AVE",
            "city": "CRETE",
            "state": "IL",
            "postal_code": "604178001",
            "telephone_number": "319-651-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR PALACE ADULT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CERTIFIED ADULT DAYCARE PROVIDER",
        "authorized_official_telephone_number": "319-651-8351"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee D Rogers
• Carolyn Rudolf, M.A., NCSP
• Sade Saunders
• Caren Marie Schranz, DROT, MS OTRL
• Rayna Schulteis
• Helen Seretis, LPC
• Breonna Simmons, MSW, LSW
• Juanita Louise Smith
• Kayla A Smith
• Claudia Solis, LSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Crete, IL
• Providers in Crete, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.