Southern Iowa Independent Living, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

SOUTHERN IOWA INDEPENDENT LIVING, INC.

Practice address

2219 W Hills Dr
Fairfield, IA 52556-4739

Phone

(641) 919-8003

NPI assigned

Dec 7, 2015

Organization subpart

No

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

Authorized official

Name

Judy Ann Alexander, LBSW

Title

Ceo

Phone

(641) 919-8003

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1659746360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 W HILLS DR",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525564739",
            "telephone_number": "641-919-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 W HILLS DR",
            "city": "FAIRFIELD",
            "state": "IA",
            "postal_code": "525564739",
            "telephone_number": "641-919-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN IOWA INDEPENDENT LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-919-8003",
        "authorized_official_credential": "LBSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel H Silver, MD
• Brian K. Simmons, LISW
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• Stephen C. Vantasell, D.D.S.,P.C.
• Summit Pharmacy of Iowa, Inc
• Sunny Brook Living Care Center, L.C.
• Sunnybrook Assisted Living, Inc.
• Sunnybrook Home Care, Inc.

• Mental Illness Community Based Residential Treatment Facility in Fairfield, IA
• Providers in Fairfield, IA by specialty
• Mental Illness Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.