Light of Faith Comm. Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

X000200331 Issued in IA

Legal business name

LIGHT OF FAITH COMM. SERVICES

Practice address

1317 N. Elm St.
Ottuwa, IA 52501

Phone

(641) 682-0023

Fax

(641) 682-1777

NPI assigned

Jan 9, 2008

Last updated

Jul 11, 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

Ms. Angela Lynn Fiscella

Title

Program Director

Phone

(641) 682-0023

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1073798989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N. ELM ST.",
            "city": "OTTUWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-682-0023",
            "fax_number": "641-682-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N. ELM ST.",
            "city": "OTTUWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-682-0023",
            "fax_number": "641-682-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT OF FAITH COMM. SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "FISCELLA",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "641-682-0023",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IA",
            "license": "X000200331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "X00020031",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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