Center Village, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

890403 Issued in IA

Legal business name

CENTER VILLAGE, INC.

Practice address

19248 Maple Ave
Keosauqua, IA 52565-8288

Phone

(319) 293-3107

Fax

(319) 293-3885

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Karla N Winslow

Title

Executive Director

Phone

(319) 293-3107

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1376670034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19248 MAPLE AVE",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525658288",
            "telephone_number": "319-293-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19248 MAPLE AVE",
            "city": "KEOSAUQUA",
            "state": "IA",
            "postal_code": "525658288",
            "telephone_number": "319-293-3107",
            "fax_number": "319-293-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "WINSLOW",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-293-3107",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": "0895839",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IA",
            "license": "890403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Keosauqua, IA
• Mental Illness Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.