Country Winds Manor, Inc.

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

CCDI-478 Issued in IA

Legal business name

COUNTRY WINDS MANOR, INC.

Doing business as

Patty Elwood Center

Practice address

21668 80TH St
Cresco, IA 52136-8412

Phone

(563) 547-2398

Fax

(563) 547-4274

NPI assigned

Oct 10, 2006

Last updated

Oct 6, 2016By 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. Patrick D Ogden

Title

Administrator

Phone

(563) 547-2398

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Patty Elwood Center Doing business as

Locations

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1104914639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21668 80TH ST",
            "city": "CRESCO",
            "state": "IA",
            "postal_code": "521368412",
            "telephone_number": "563-547-2398",
            "fax_number": "563-547-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21668 80TH ST",
            "city": "CRESCO",
            "state": "IA",
            "postal_code": "521368412",
            "telephone_number": "563-547-2398",
            "fax_number": "563-547-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY WINDS MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "OGDEN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "563-547-2398",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IA",
            "license": "CCDI-478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0809079",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patty Elwood Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alzheimer Center (Dementia Center) in Cresco, IA
• Providers in Cresco, 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 6, 2016; 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.