Mallard View Inc

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

001 Issued in IA

Legal business name

MALLARD VIEW INC

Practice address

17504 Mahogany Ave
Carroll, IA 51401-8870

Phone

(712) 792-3785

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Stacey Peter

Title

Administrator

Phone

(712) 792-3785

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245387299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17504 MAHOGANY AVE",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514018870",
            "telephone_number": "712-792-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17504 MAHOGANY AVE",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514018870",
            "telephone_number": "712-792-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLARD VIEW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PETER",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "712-792-3785"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "IA",
            "license": "001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0895243",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Carroll, IA
• Providers in Carroll, IA by specialty
• Assisted Living Facility (Mental Illness) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.