Kismet Alt-a, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

S0096 Issued in IA

Legal business name

KISMET ALT-A, LLC

Doing business as

WEL-Life at Alta

Practice address

705 W 7TH St
Alta, IA 51002-1525

Phone

(712) 200-2620

Fax

(712) 200-1174

NPI assigned

Feb 3, 2016

Last updated

Jul 15, 2021By 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

Michael L. Moore

Title

Chief Financial Officer

Phone

(605) 642-7736

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WEL-Life at Alta Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1366800450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W 7TH ST",
            "city": "ALTA",
            "state": "IA",
            "postal_code": "510021525",
            "telephone_number": "712-200-2620",
            "fax_number": "712-200-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W 7TH ST",
            "city": "ALTA",
            "state": "IA",
            "postal_code": "510021525",
            "telephone_number": "712-200-2620",
            "fax_number": "712-200-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISMET ALT-A, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "605-642-7736"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IA",
            "license": "S0096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047972E",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WEL-Life at Alta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Alta, IA
• Providers in Alta, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.