Promise House Hiawatha Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PROMISE HOUSE HIAWATHA INC.

Practice address

1320 Litchfield Dr
Hiawatha, IA 52233-2343

Phone

(319) 743-9812

NPI assigned

Mar 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kent Walton

Title

Administrator

Phone

(319) 378-8583

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1003086604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N 15TH AVE",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332347",
            "telephone_number": "319-378-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LITCHFIELD DR",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332343",
            "telephone_number": "319-743-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE HOUSE HIAWATHA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "319-378-8583"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hiawatha, IA
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.