NPIMap

Organization Active NPI

Comprehensive Systems, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Waterloo, IA
National Provider Identifier
1477617264
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
070971 Issued in IA
Legal business name
COMPREHENSIVE SYSTEMS, INC
Practice address
2266 Country LN
Waterloo, IA 50701-9736
Phone
(641) 228-4842
Fax
(641) 228-4675
NPI assigned
Dec 19, 2006
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
Jack Brown
Title
Executive Director
Phone
(641) 228-4842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 070971 IA Primary

Addresses

Primary practice location

2266 Country LN
Waterloo, IA 50701-9736

Mailing address

1700 Clark St
PO Box 457
Charles City, IA 50616-0457
Phone (641) 228-4842

Other identifiers 1

IdentifierTypeStateIssuer
0881490MedicaidIA

Other names 1

  • Country Lane ICFMR Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477617264. Details of each certification follow.

  • CCN 16G130 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 16G130

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COUNTRY LANE GROUP HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 6, 1999
Last certification
Jul 30, 2025
Beds
5
Ownership / control type
Private (non-profit)
Facility address
2266 Country Lane
Waterloo, IA 50701

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Systems Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

2266 Country Ln
Waterloo, IA 50701

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477617264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 CLARK ST",
            "address_2": "PO BOX 457",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506160457",
            "telephone_number": "641-228-4842",
            "fax_number": "641-228-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 COUNTRY LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507019736",
            "telephone_number": "641-228-4842",
            "fax_number": "641-228-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "641-228-4842"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IA",
            "license": "070971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881490",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Lane ICFMR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.