NPIMap

Organization Active NPI

Avalon Center

  • Community/Behavioral Health Agency
  • Mason City, IA
National Provider Identifier
1003969148
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AVALON CENTER
Practice address
22 N Georgia Ave
Suite #102
Mason City, IA 50401-3435
Phone
(641) 422-0070
Fax
(641) 422-0060
NPI assigned
Jan 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Authorized official

Name
Mrs. Leah Jean Weber, LBSW, CADC, MANPI 1073895348
Title
Executive Director
Phone
(641) 422-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

22 N Georgia Ave
Suite #102
Mason City, IA 50401-3435

Mailing address

22 N Georgia Ave
Suite #102
Mason City, IA 50401-3435
Phone (641) 422-0070

Other identifiers 1

IdentifierTypeStateIssuer
1012138MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160613000797 IA Part B Supplier - Clinic/Group Practice 9032409594 Receives reassigned benefits from 3 practitioners
Practice locations: Charles City, IA; Mason City, IA; Osage, IA

National Provider Directory

National Provider Directory

Locations

1202 S Main St
Charles City, IA 50616
Phone (641) 715-1183

705 N Main St
Ste 2
Charles City, IA 50616
Phone (641) 715-1183

22 N Georgia Ave
Ste 102
Mason City, IA 50401
Phone (641) 422-0070

415 Pleasant St
Osage, IA 50461
Phone (641) 424-2075

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1003969148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N GEORGIA AVE",
            "address_2": "SUITE #102",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504013435",
            "telephone_number": "641-422-0070",
            "fax_number": "641-422-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N GEORGIA AVE",
            "address_2": "SUITE #102",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504013435",
            "telephone_number": "641-422-0070",
            "fax_number": "641-422-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "641-422-0070",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LBSW, CADC, MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012138",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.