Homestead of Estherville Operations LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HOMESTEAD OF ESTHERVILLE OPERATIONS LLC

Practice address

2015 3Rd Ave N
Estherville, IA 51334-1740

Phone

(712) 362-0171

NPI assigned

Jan 11, 2022

Organization subpart

No

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

Authorized official

Name

Cody Fulks, CPA

Title

Cfo

Phone

(785) 272-1535

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": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1013668151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 SW WANAMAKER RD STE 300",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666144498",
            "telephone_number": "785-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 3RD AVE N",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341740",
            "telephone_number": "712-362-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD OF ESTHERVILLE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "FULKS",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "785-272-1535",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Estherville, IA
• Providers in Estherville, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.