Knoxville Residential, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

630299 Issued in IA

Legal business name

KNOXVILLE RESIDENTIAL, LLC

Doing business as

Knoxville Residential

Practice address

205 N Iowa St
Knoxville, IA 50138-2833

Phone

(641) 842-4618

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By 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

Russell Lee Hemness

Title

Owner

Phone

(515) 250-0670

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Knoxville Residential Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce William Boehm Jr.

  • Mental Illness Community Based Residential Treatment Facility
  • Knoxville, IA
  • NPI 1437719937

  Community Based Residential Treatment Facility, Mental Illness

  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912088659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5095 WINDSOR CIR",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503270908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N IOWA ST",
            "city": "KNOXVILLE",
            "state": "IA",
            "postal_code": "501382833",
            "telephone_number": "641-842-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEMNESS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-250-0670"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IA",
            "license": "630299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0896886",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knoxville Residential",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Knoxville Community Hospital Inc (Knoxville Hospital & Clinics)
• Knoxville Community Hospital Inc. (Knoxville Hospital and Clinics)
• Knoxville Community School District
• Knoxville Dental Center, P.C. (Knoxville Dental Center)
• Knoxville Hospital and Clinics
• KNX Dental Enterprises, LLC
• Kayle Kosman, CADC
• Tatjana Kumor
• Brian D Lange, D. C.
• Allison Sue Lanphier, PA

• Mental Illness Community Based Residential Treatment Facility in Knoxville, IA
• Providers in Knoxville, 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 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.