Provider Demographics
NPI:1437338282
Name:TOMLONSON GROUP CARE HOME
Entity Type:Organization
Organization Name:TOMLONSON GROUP CARE HOME
Other - Org Name:TOMLONSON ISL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMLONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-827-1419
Mailing Address - Street 1:2872 SOUTHGATE LOOP
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-8842
Mailing Address - Country:US
Mailing Address - Phone:660-827-1419
Mailing Address - Fax:
Practice Address - Street 1:112 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2337
Practice Address - Country:US
Practice Address - Phone:660-851-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities