Organization
INDIANOLA RESIDENTIAL, LLC
Active
Organization
INDIANOLA RESIDENTIAL, LLC
Active
Other names
Indianola Residential
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL LEE HEMNESS (OWNER)
(515) 250-0670
Entity
Organization
Contact information
Practice address
401 W SALEM AVE, INDIANOLA, IA 50125-2439
(515) 961-2556
Mailing address
5095 WINDSOR CIR, PLEASANT HILL, IA 50327-0908
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
910290
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0896910
—
IA
Enumeration date
10/18/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up