Shenandoah Iowa Assiste Living Facility LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

S0328 Issued in IA

Legal business name

SHENANDOAH IOWA ASSISTE LIVING FACILITY LLC

Doing business as

Windsor Manor Shenandoah

Practice address

601 Harrison St
Shenandoah, IA 51601-2019

Phone

(712) 246-2194

Fax

(712) 246-6182

NPI assigned

Oct 2, 2013

Last updated

Oct 2, 2013By 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

Elizabeth Ann Marie McCalla

Title

Executive Director

Phone

(712) 246-2194

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Windsor Manor Shenandoah Doing business as

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1083041206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HARRISON ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012019",
            "telephone_number": "712-246-2194",
            "fax_number": "712-246-6182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HARRISON ST",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012019",
            "telephone_number": "712-246-2194",
            "fax_number": "712-246-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH IOWA ASSISTE LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "MCCALLA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "712-246-2194"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IA",
            "license": "S0328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTED LIVING PROGRAM CERTIFICATE - DEPARTMENT OF INSPECTIONS AND APPEALS",
            "identifier": "S0328",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windsor Manor Shenandoah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shenandoah Care Center, LLC (Garden View Care Center)
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• Shenandoah Family Dentistry, P.C.
• Shenandoah Medical Center (SMC Home Health and Hospice)
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center
• Shenandoah Medical Center

• Alzheimer Center (Dementia Center) in Shenandoah, IA
• Providers in Shenandoah, IA by specialty
• Alzheimer Center (Dementia Center) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.