NPIMap

Organization Active NPI

Developmental Resources, Inc.

Doing business as Krysilis, Inc.-Ashwood

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Forest City, IA
National Provider Identifier
1962478172
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
950507 Issued in IA
Legal business name
DEVELOPMENTAL RESOURCES, INC.
Doing business as
Krysilis, Inc.-Ashwood
Practice address
825 S 7TH St
Forest City, IA 50436-2127
Phone
(641) 585-2377
NPI assigned
Feb 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Brent V Aberg
Title
Executive Director
Phone
(641) 585-5450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 950507 IA Primary

Addresses

Primary practice location

825 S 7TH St
Forest City, IA 50436-2127

Mailing address

102 W Park St
Forest City, IA 50436-2132
Phone (641) 585-5450

Other identifiers 2

IdentifierTypeStateIssuer
0880591MedicaidIA
IA04205OtherIASUBMITTER ID

Other names 1

  • Krysilis, Inc.-Ashwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Developmental Resources Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

102 W Park St
Forest City, IA 50436
Phone (641) 585-3050

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962478172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PARK ST",
            "city": "FOREST CITY",
            "state": "IA",
            "postal_code": "504362132",
            "telephone_number": "641-585-5450",
            "fax_number": "641-585-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S 7TH ST",
            "city": "FOREST CITY",
            "state": "IA",
            "postal_code": "504362127",
            "telephone_number": "641-585-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABERG",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "641-585-5450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": "950507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880591",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBMITTER ID",
            "identifier": "IA04205",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Krysilis, Inc.-Ashwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest City, IA

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.