NPIMap

Organization Active NPI

Shinn Residential Center, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Hannibal, MO
National Provider Identifier
1851436828
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
2462-9303 Issued in MO
Legal business name
SHINN RESIDENTIAL CENTER, INC.
Practice address
805 Paris Ave
Shinn Residential Center III
Hannibal, MO 63401-3223
Phone
(573) 221-3764
Fax
(573) 221-6225
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gary Shinn
Title
President
Phone
(573) 406-1523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 2462-9303 MO Primary

Addresses

Primary practice location

805 Paris Ave
Shinn Residential Center III
Hannibal, MO 63401-3223

Mailing address

817 Paris Ave
Hannibal, MO 63401-3223
Phone (573) 406-1523

National Provider Directory

National Provider Directory
Tax ID family
Shinn Residential Center Inc3 organizations share this tax ID, including this one

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851436828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 PARIS AVE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013223",
            "telephone_number": "573-406-1523",
            "fax_number": "573-248-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PARIS AVE",
            "address_2": "SHINN RESIDENTIAL CENTER III",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634013223",
            "telephone_number": "573-221-3764",
            "fax_number": "573-221-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINN RESIDENTIAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHINN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-406-1523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "2462-9303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.