Organization
KNOXVILLE RESIDENTIAL, LLC
Active
Organization
KNOXVILLE RESIDENTIAL, LLC
Active
Other names
Knoxville Residential
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL LEE HEMNESS (OWNER)
(515) 250-0670
Entity
Organization
Contact information
Practice address
205 N IOWA ST, KNOXVILLE, IA 50138-2833
(641) 842-4618
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
630299
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0896886
—
IA
Enumeration date
10/18/2006
Last updated
08/22/2020
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