Signature Properties of Paullina LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

710356 Issued in IA

Legal business name

SIGNATURE PROPERTIES OF PAULLINA LLC

Doing business as

Paullina Care Center

Practice address

423 N Willow St
Paullina, IA 51046-1003

Phone

(712) 448-3455

Fax

(712) 448-2283

NPI assigned

Nov 15, 2005

Last updated

Mar 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bruce Mehlhop

Title

Managing Member

Phone

(515) 727-1768

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Paullina Care Center Doing business as

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1023090255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N WILLOW ST",
            "city": "PAULLINA",
            "state": "IA",
            "postal_code": "510461003",
            "telephone_number": "712-448-3455",
            "fax_number": "712-448-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N WILLOW ST",
            "city": "PAULLINA",
            "state": "IA",
            "postal_code": "510461003",
            "telephone_number": "712-448-3455",
            "fax_number": "712-448-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROPERTIES OF PAULLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "MEHLHOP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "515-727-1768",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "710356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805069",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paullina Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Paullina, IA
• Providers in Paullina, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.