The Jody House Isl Company LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

THE JODY HOUSE ISL COMPANY LLC

Practice address

407 E 6TH St
Rolla, MO 65401-3368

Phone

(573) 465-3654

Fax

(888) 858-8055

NPI assigned

Mar 2, 2009

Last updated

Mar 2, 2009By 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

Chad Robert Lewis

Title

Director

Phone

(573) 465-3654

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1275773376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 E 6TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013368",
            "telephone_number": "573-465-3654",
            "fax_number": "888-858-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 6TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013368",
            "telephone_number": "573-465-3654",
            "fax_number": "888-858-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JODY HOUSE ISL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-465-3654"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura W. Taylor, PA
• Peggy Taylor, RN
• Janice Tejeda, LMSW
• The Curators of the University of Missouri
• The Jody House
• The Robert L. Kyle Center for Semi-Independent Living
• The Robert L. Kyle Center for Semi-Independent Living
• Theresa Heckman Occupational Therapist
• Erin Marie Thiltgen, ATC
• Samantha Dayle Thomlinson, PLPC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Rolla, MO
• Providers in Rolla, MO by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; 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.