Hickory Heights

Primary specialty

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

Legal business name

HICKORY HEIGHTS

Practice address

1202 Hickory St
Victoria, KS 67671-9310

Phone

(785) 735-9236

NPI assigned

Aug 13, 2008

Last updated

Aug 13, 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. Anjeanette T Roth

Title

Administrator

Phone

(785) 735-9236

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1619123486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 HICKORY ST",
            "city": "VICTORIA",
            "state": "KS",
            "postal_code": "676719310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HICKORY ST",
            "city": "VICTORIA",
            "state": "KS",
            "postal_code": "676719310",
            "telephone_number": "785-735-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY HEIGHTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "ANJEANETTE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-735-9236",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Victoria, KS
• Providers in Victoria, KS by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.