NPIMap

Organization Active NPI

Jays Residential Isl

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Grandview, MO
National Provider Identifier
1285751826
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
JAYS RESIDENTIAL ISL
Practice address
12731 Richmond Ave
Grandview, MO 64030-2160
Phone
(816) 456-6461
Fax
(816) 965-0131
NPI assigned
Mar 26, 2007
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
Jason Lee Rudolph, BS
Title
Director
Phone
(816) 456-6461

Specialties & licenses 1

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

Addresses

Primary practice location

12731 Richmond Ave
Grandview, MO 64030-2160

Mailing address

12731 Richmond Ave
Grandview, MO 64030-2160
Phone (816) 456-6461

National Provider Directory

National Provider Directory
Tax ID family
Jays Residential Isl4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285751826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12731 RICHMOND AVE",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302160",
            "telephone_number": "816-456-6461",
            "fax_number": "816-965-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12731 RICHMOND AVE",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640302160",
            "telephone_number": "816-456-6461",
            "fax_number": "816-965-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYS RESIDENTIAL ISL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "816-456-6461",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandview, MO

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.