HICKORY HEIGHTS (NPI# 1619123486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619123486 |
| Entity Type | Organization |
| Organization Name | HICKORY HEIGHTS |
| Practice Address |
1202 Hickory St Victoria KS 67671-9310 |
| Practice Telephone | 7857359236 |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2008-08-13 |
| Authorized Official Name | MRS. ANJEANETTE T ROTH (ADMINISTRATOR) |
| Authorized Official Telephone | 7857359236 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HICKORY HEIGHTS APARTMENTS | 1108 Cambridge St, Abbeville, SC 29620-2803 |
| Colorado Business Entities | Hickory Heights Investments LLC | 69 W. Bayaud Ave., Denver, CO 80223 |
| Street Address |
1202 HICKORY ST |
| City | VICTORIA |
| State | KS |
| Zip Code | 67671-9310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306271275 | Delores Ann Schmeidler | Nurse Practitioner | 208 Mare Wagner Road, Victoria, KS 67671 | 2013-09-10 |
| 1073765277 | Maren K Moody | Nurse Practitioner | 208 Marc Wagner Drive, Victoria, KS 67671 | 2008-10-21 |
| 1841233913 | St. John's Inc. | Nurse Practitioner | 208 Marc Wagner Rd, Victoria, KS 67671 | 2006-06-14 |
| 1609184100 | Krista D. Braun | Physical Therapy Assistant | 701 7th St, Victoria, KS 67671 | 2010-09-17 |
| 1891028353 | Usd 432 Victoria | Local Education Agency (LEA) | 804 Cathedral, Victoria, KS 67671-9413 | 2009-09-15 |
| 1770636656 | St. Johns, Inc. | Nursing Facility/Intermediate Care Facility | 701 7th St, Victoria, KS 67671-9527 | 2007-01-22 |
| 1922207232 | Roselin Pfeifer | Occupational Therapy Assistant | 701 7th St, Victoria, KS 67671-9527 | 2007-07-16 |
| 1609349844 | Golden Rule Health | Clinic/Center | 416 Main St, Victoria, KS 67671-9562 | 2019-01-10 |
| 1548636665 | First Care Clinic, Inc. | Clinic/Center | 208 Marc Wagner Dr, Victoria, KS 67671-9589 | 2015-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184230278 | Stephanie Roddy | Registered Nurse | 74 Wally Ln, Victoria, TX 77905-3723 | 2020-09-23 |
| 1356957591 | Bradley Bomba | Registered Nurse | 302 Yosemite Dr, Victoria, TX 77904-3662 | 2020-09-22 |
| 1801401856 | Denise Mary Tomanek | Family Medicine | 218 Cobble Stone Ct, Victoria, TX 77904-2975 | 2020-09-15 |
| 1538773163 | Regional Pathology Associates, Pllc | Clinical Medical Laboratory | 2709 N Ben Wilson St, Victoria, TX 77901-5728 | 2020-09-01 |
| 1457962540 | Uc Management Group LLC | Nurse Practitioner | 1908 N Laurent St Ste 410, Victoria, TX 77901 | 2020-08-12 |
| 1114536166 | Jennifer Foxell Bluntzer | Nurse Practitioner | 117 Andrew Dr, Victoria, TX 77904-2935 | 2020-07-27 |
| 1952927964 | His House Foundation | Case Management | 1866 Woodstone Dr, Victoria, MN 55386-9634 | 2020-06-25 |
| 1205452885 | Amy Nicole Varela | Doula | 2701 Leary Ln Trlr 82, Victoria, TX 77901-2933 | 2020-06-19 |
| 1952925174 | Emily Ann Carroll | Registered Nurse | 2402 E Mimosa Ave, Victoria, TX 77901-3519 | 2020-06-03 |
| 1306478177 | Elizabeth Thompson | Licensed Vocational Nurse | 456 Price Rd, Victoria, TX 77905-2522 | 2020-02-10 |
| Find all providers in VICTORIA | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285668541 | Gulf Bend Mrmr Center Hcs Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6502 Nursery Dr, Suite 100, Victoria, TX 77904-1178 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124630132 | Elite Adult Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5001 Looman St, Wichita, KS 67220-3030 | 2020-08-20 |
| 1720603186 | Beverly Jean Weber Cobb | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3829 Sw Wood Valley Dr, Topeka, KS 66610-1124 | 2020-06-11 |
| 1073174918 | Keith Lavelle Kerr Jr. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2914 N 38th St, Kansas City, KS 66104-2526 | 2019-06-21 |
| 1912444548 | Developmental Services of Northwest Kansas, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2703 Hall St Ste 10, Hays, KS 67601-1964 | 2017-01-20 |
| 1255785275 | Lindsey Marts | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8809 Grandview St, Overland Park, KS 66212-3643 | 2016-04-15 |
| 1952774184 | Joyce's New Vision LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1801 S 40th St, Kansas City, KS 66106-2607 | 2015-11-10 |
| 1336518976 | Pearlie Mae's Compassion and Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2956 Sw Seabrook Ave, Topeka, KS 66614 | 2015-09-24 |
| 1366861197 | Karen Frye | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4214 N 143rd St E, Wichita, KS 67228-8943 | 2014-04-09 |
| 1427474485 | Joyce Ann Maley | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1036 2200th St, Iola, KS 66749-3085 | 2014-03-13 |
| 1174947113 | Avance-d Comminuty Alternatives, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7424 Sw 33rd St, Topeka, KS 66614-4663 | 2014-02-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.