Exners Basic Care Inc

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

030766 Issued in ND

Legal business name

EXNERS BASIC CARE INC

Doing business as

Gackle Care Center

Practice address

304 1St Ave W
Gackle, ND 58442-0335

Phone

(701) 485-3395

Fax

(701) 485-3962

NPI assigned

Nov 17, 2006

Last updated

Aug 22, 2020By 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

Timothy M Exner

Title

Administrator Owner

Phone

(701) 485-3395

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gackle Care Center Doing business as

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336213818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335",
            "address_2": "3040 1ST AVE W",
            "city": "GACKLE",
            "state": "ND",
            "postal_code": "584420335",
            "telephone_number": "701-485-3395",
            "fax_number": "701-485-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 1ST AVE W",
            "city": "GACKLE",
            "state": "ND",
            "postal_code": "584420335",
            "telephone_number": "701-485-3395",
            "fax_number": "701-485-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXNERS BASIC CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EXNER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR OWNER",
        "authorized_official_telephone_number": "701-485-3395"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "ND",
            "license": "030766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030766",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gackle Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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.