NPIMap

Organization Active NPI

Developmental Resourcs, Inc.

Doing business as Krysilis, Inc.-Waiver Svs

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Clarion, IA
National Provider Identifier
1285600312
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DEVELOPMENTAL RESOURCS, INC.
Doing business as
Krysilis, Inc.-Waiver Svs
Practice address
210 2ND St NW
Clarion, IA 50525-1005
Phone
(515) 532-3221
Fax
(515) 532-6630
NPI assigned
Feb 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Brent V Aberg
Title
Executive Director
Phone
(641) 585-5450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X IA Primary

Addresses

Primary practice location

210 2ND St NW
Clarion, IA 50525-1005

Mailing address

102 W Park St
Forest City, IA 50436-2132
Phone (641) 585-5450

Other identifiers 2

IdentifierTypeStateIssuer
0120543MedicaidIA
IA03792OtherIASUBMITTER ID

Other names 1

  • Krysilis, Inc.-Waiver Svs Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Developmental Resources Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285600312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PARK ST",
            "city": "FOREST CITY",
            "state": "IA",
            "postal_code": "504362132",
            "telephone_number": "641-585-5450",
            "fax_number": "641-585-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 2ND ST NW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505251005",
            "telephone_number": "515-532-3221",
            "fax_number": "515-532-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL RESOURCS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABERG",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "641-585-5450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120543",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER ID",
            "identifier": "IA03792",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Krysilis, Inc.-Waiver Svs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarion, IA

Sources for this page

  • 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.