Indianola Residential, LLC

NPI #1255412995 in Indianola, Iowa

Provider Information

NPI Number: 1255412995
Entity Type: Organization
Organization Name: Indianola Residential, LLC
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Oct 18, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 401 W SALEM AVE
City: Indianola
State: Iowa
ZIP Code: 50125-2439
Phone: (515) 961-2556

Authorized Official

Name: RUSSELL LEE HEMNESS
Title: OWNER
Phone: (515) 250-0670

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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