NPIMap

Organization Active NPI

St Jude Retreat House, LLC

  • Psychiatry Physician
  • Des Moines, IA
National Provider Identifier
1538566732
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ST JUDE RETREAT HOUSE, LLC
Practice address
5875 Fleur Dr
Des Moines, IA 50321-2883
Phone
(515) 421-4066
NPI assigned
Dec 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Authorized official

Name
Tim F Carson
Title
Cfo
Phone
(515) 298-7209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5875 Fleur Dr
Des Moines, IA 50321-2883

Mailing address

5875 Fleur Dr
Des Moines, IA 50321-2883
Phone (515) 421-4066

Other names 1

  • ALPP Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alpp Institute6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

5875 Fleur Dr
Des Moines, IA 50321
Phone (515) 298-7209

NPI Registry JSON

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417564800000",
    "number": "1538566732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 FLEUR DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503212883",
            "telephone_number": "515-421-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 FLEUR DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503212883",
            "telephone_number": "515-421-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JUDE RETREAT HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2014-12-03",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "515-298-7209"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALPP Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.