River to River Community of Ullin

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0583795 Issued in IL

Legal business name

RIVER TO RIVER COMMUNITY OF ULLIN

Practice address

751 Ullin Ave
Ullin, IL 62992-1014

Phone

(618) 845-9065

NPI assigned

Feb 3, 2017

Last updated

Feb 3, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherry Barter Hamlin

Title

Ceo

Phone

(618) 993-7533

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1245778810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1759",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 ULLIN AVE",
            "city": "ULLIN",
            "state": "IL",
            "postal_code": "629921014",
            "telephone_number": "618-845-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER TO RIVER COMMUNITY OF ULLIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "BARTER HAMLIN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-993-7533"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "0583795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0583795",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn D. Kissiar, CNP
• Lesa Kelly Klosterhoff, PT
• Mary Livesay
• Caitlin M. Marks, SLP
• Sara Paige Nighswander, MS SCHOOL PSYCHOLOGY
• Southern Seven Health Dept
• Leslie Elaine Thurston, M.S., CCC-SLP
• Shirley M. Woodard, DEVELOPMENTAL THERAP

• Assisted Living Facility in Ullin, IL
• Providers in Ullin, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; 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.