Spectra Health Care, Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

R0175 Issued in IA

Legal business name

SPECTRA HEALTH CARE, INC.

Practice address

5726 120TH Ave
Storm Lake, IA 50588-7568

Phone

(712) 732-4118

Fax

(712) 732-4119

NPI assigned

Oct 18, 2006

Last updated

Aug 22, 2020By 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

Sue Morrow

Title

Administrator

Phone

(712) 284-1739

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063593960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W 7TH ST",
            "city": "ALTA",
            "state": "IA",
            "postal_code": "510021540",
            "telephone_number": "712-284-1739",
            "fax_number": "712-284-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 120TH AVE",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505887568",
            "telephone_number": "712-732-4118",
            "fax_number": "712-732-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRA HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "712-284-1739"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IA",
            "license": "R0175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462580",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893875",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0230763",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Adult Care Home Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.