Holland Residential Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HOLLAND RESIDENTIAL SERVICES, INC.

Practice address

12510 Jackson Ave
Grandview, MO 64030-1593

Phone

(816) 982-9481

NPI assigned

Apr 28, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Shawana Jenkins, MPA, MSW

Title

Executive Director

Phone

(816) 982-9481

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1556409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556409600000",
    "number": "1427612134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 JACKSON AVE",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301593",
            "telephone_number": "816-982-9481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12510 JACKSON AVE",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301593",
            "telephone_number": "816-982-9481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLAND RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-28",
        "last_updated": "2019-04-28",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "SHAWANA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "816-982-9481",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPA, MSW"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2019; 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.