Pearl Valley Rehabilitation and Nursing at Lake Park, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PEARL VALLEY REHABILITATION AND NURSING AT LAKE PARK, LLC

Practice address

1304 S Market St
Lake Park, IA 51347-1060

Phone

(712) 832-3691

NPI assigned

Jan 3, 2017

Organization subpart

No

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

Authorized official

Name

Yaakov Dorfman

Title

Owner (Greater Than 5 Percent)

Phone

(551) 206-2647

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1124563994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 E 27TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 S MARKET ST",
            "city": "LAKE PARK",
            "state": "IA",
            "postal_code": "513471060",
            "telephone_number": "712-832-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL VALLEY REHABILITATION AND NURSING AT LAKE PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "DORFMAN",
        "authorized_official_first_name": "YAAKOV",
        "authorized_official_title_or_position": "OWNER (GREATER THAN 5 PERCENT)",
        "authorized_official_telephone_number": "551-206-2647"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Park SNF Operator LLC
• Tina Maria McClure
• Niemeier Spine & Sports Chiropractic PLC
• Billi Niemeier, FNP
• Chad Michael Niemeier, D.C.
• Sanford Health Network
• Signature Properties of Lake Park, LLC
• Sioux Valley Regional Health Services
• Elizabeth Stokke, FNP-C
• Kayla Updike, D.C.

• Skilled Nursing Facility in Lake Park, IA
• Providers in Lake Park, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.