NPIMap

Organization Active NPI

Handicap Village

Doing business as Opportunity Village

  • Intellectual Disabilities Intermediate Care Facility
  • Clear Lake, IA
National Provider Identifier
1316098015
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
HANDICAP VILLAGE
Doing business as
Opportunity Village
Practice address
1200 N 9TH St W
Clear Lake, IA 50428-1100
Phone
(641) 357-5277
Fax
(641) 357-6491
NPI assigned
Jan 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gregory Braun
Title
Cfo
Phone
(641) 355-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X NU Primary

Addresses

Primary practice location

1200 N 9TH St W
Clear Lake, IA 50428-1100

Mailing address

PO Box 622
Clear Lake, IA 50428-0622
Phone (641) 357-5277

Other identifiers 1

IdentifierTypeStateIssuer
0880468MedicaidIA

Other names 1

  • Opportunity Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Handicap Village24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316098015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 622",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504280622",
            "telephone_number": "641-357-5277",
            "fax_number": "641-357-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N 9TH ST W",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504281100",
            "telephone_number": "641-357-5277",
            "fax_number": "641-357-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANDICAP VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRAUN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "641-355-1200"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0880468",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Opportunity Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clear Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.