ELLENDEL ISL – NPI #1235252826
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

ELLENDEL ISL is a community based residential treatment facility located in KIRKSVILLE, MO. NPPES has assigned the NPI number 1235252826 to ELLENDEL ISL on April 09, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ELLENDEL ISL” is a dba name, the actual legal business name for this organization is ELLENDEL ISL LLC. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 4 years ago on Nov 25, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ELLENDEL ISL below.

NPI Profile for
ELLENDEL ISL LLC

NPI Number
1235252826
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ELLENDEL ISL LLC
Doing Business As (dba): ELLENDEL ISL
Primary location
1108 E PATTERSON
SUITE 9
KIRKSVILLE, MO 63501
Phone: (660) 627-4101 Fax: (660) 665-0185
Mailing address
701 S JAMISON
KIRKSVILLE, MO 63501
Phone: (660) 627-4101 Fax: (660) 665-0185
Organization Subpart
No
Authorized Official
RHODA TOMICH
OWNER/MANAGER
Phone: (660) 627-4101
Updated
Certification Date
Nov 25, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.