NPIMap

Organization Active NPI

Longhouse-Northshire, LTD

  • Nursing Facility/Intermediate Care Facility
  • Spencer, IA
National Provider Identifier
1417163197
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
210065 Issued in IA
Legal business name
LONGHOUSE-NORTHSHIRE, LTD
Practice address
711 W 11TH St
Spencer, IA 51301-3237
Phone
(712) 262-2344
Fax
(712) 262-3550
NPI assigned
May 16, 2007
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
Mr. Dave W Soucek
Title
Asst Adm
Phone
(712) 262-2344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 210065 IA Primary

Addresses

Primary practice location

711 W 11TH St
Spencer, IA 51301-3237

Mailing address

711 W 11TH St
Spencer, IA 51301-3237
Phone (712) 262-2344

Other identifiers 1

IdentifierTypeStateIssuer
0894071MedicaidIA

National Provider Directory

National Provider Directory
Tax ID family
Longhouse-Northshire LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417163197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 11TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013237",
            "telephone_number": "712-262-2344",
            "fax_number": "712-262-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 11TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513013237",
            "telephone_number": "712-262-2344",
            "fax_number": "712-262-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGHOUSE-NORTHSHIRE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOUCEK",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASST ADM",
        "authorized_official_telephone_number": "712-262-2344",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IA",
            "license": "210065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0894071",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, 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.