Self-Reliance

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

X000502991 Issued in IA

Legal business name

SELF-RELIANCE

Practice address

825 N 6TH St Ste 4
Burlington, IA 52601-4920

Phone

(319) 752-4978

NPI assigned

Jun 22, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Jean Miller

Title

Executive Director

Phone

(319) 752-4978

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1831571306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N 6TH ST STE 4",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014920",
            "telephone_number": "319-752-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N 6TH ST STE 4",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526014920",
            "telephone_number": "319-752-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF-RELIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-752-4978",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IA",
            "license": "X000502991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "X000502991",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille Schulz
• Eleanor Angeline Schupick, M.A., CADC
• Eric Leigh Schweizer, DC
• Christina Marie Scott
• Sara J Scott, LMHC, NCC
• Beverly Sherbondy, C.C.C.-SLP
• David A Sherbondy, DC
• Eric James Shipley, ARNP, FNP-BC
• Matthew J Shivers, R.PH.
• Jennifer D. Shook, LCSW

• Developmentally Disabled Services Day Training Agency in Burlington, IA
• Providers in Burlington, IA by specialty
• Developmentally Disabled Services Day Training Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.