William Eadie Residential Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

R-880682 & R-880683 Issued in IA

Legal business name

WILLIAM EADIE RESIDENTIAL SERVICES, INC.

Doing business as

Care

Practice address

500 Opal St
Afton, IA 50830-1078

Phone

(641) 347-5611

Fax

(641) 347-5038

NPI assigned

Jan 29, 2007

Last updated

Jun 25, 2008By 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

Mrs. Jean M Rommes, PH.D.

Title

President

Phone

64178288495

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• CARE Doing business as

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1255477329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OPAL ST",
            "city": "AFTON",
            "state": "IA",
            "postal_code": "508301078",
            "telephone_number": "641-347-5611",
            "fax_number": "641-347-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OPAL ST",
            "city": "AFTON",
            "state": "IA",
            "postal_code": "508301078",
            "telephone_number": "641-347-5611",
            "fax_number": "641-347-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM EADIE RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "ROMMES",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "64178288495",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IA",
            "license": "R-880682 & R-880683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895482",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233528",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0463406",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Afton, IA
• Providers in Afton, IA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.