Ameritus Iowa Cedarvale Whispering Willows LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AMERITUS IOWA CEDARVALE WHISPERING WILLOWS LLC

Practice address

601 Dawn Ave
Fredericksburg, IA 50630-1033

Phone

(563) 237-5075

NPI assigned

Nov 22, 2022

Organization subpart

No

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

Authorized official

Name

Mark Dickson

Title

Owner

Phone

(507) 202-8880

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1033828645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BROADWAY AVE S STE 460",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559047005",
            "telephone_number": "507-202-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DAWN AVE",
            "city": "FREDERICKSBURG",
            "state": "IA",
            "postal_code": "506301033",
            "telephone_number": "563-237-5075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Poppe Ln Apt 100",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "IA",
            "postal_code": "506589705",
            "country_code": "US",
            "telephone_number": "641-435-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMERITUS IOWA CEDARVALE WHISPERING WILLOWS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-202-8880"
    },
    "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 Fredericksburg, IA
• Providers in Fredericksburg, 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 Nov 22, 2022; 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.