NPIMap

Organization Active NPI

Samuel and Jill Hieronymus

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Warsaw, MO
National Provider Identifier
1790138956
Registry record updated Aug 4, 2016
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
SAMUEL AND JILL HIERONYMUS
Doing business as
Twin Oaks Independent Living II
Practice address
127 Tower Dr
Warsaw, MO 65355-3439
Phone
(660) 335-0091
Fax
(660) 335-0092
NPI assigned
Jul 22, 2016
Organization subpart
Yes
Parent organization
SAMUEL AND JILL HIERONYMUSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Authorized official

Name
Mrs. Jill Hieronymus
Title
Owner
Phone
(660) 335-0091

Specialties & licenses 1

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

Addresses

Primary practice location

127 Tower Dr
Warsaw, MO 65355-3439

Mailing address

PO Box 204
Sweet Springs, MO 65351-0204
Phone (660) 335-0091

Other names 1

  • Twin Oaks Independent Living II Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Samuel and Jill Hieronymus3 organizations share this tax ID, including this one
Part of
Samuel and Jill Hieronymus

Other organizations with this tax ID 2

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": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470268800000",
    "number": "1790138956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "SWEET SPRINGS",
            "state": "MO",
            "postal_code": "653510204",
            "telephone_number": "660-335-0091",
            "fax_number": "660-335-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 TOWER DR",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653553439",
            "telephone_number": "660-335-0091",
            "fax_number": "660-335-0092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL AND JILL HIERONYMUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMUEL AND JILL HIERONYMUS",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-08-04",
        "status": "A",
        "authorized_official_last_name": "HIERONYMUS",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-335-0091",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Oaks Independent Living II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warsaw, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.