NPIMap

Organization Active NPI

Waukon Ia Skilled Nursing Facility, LLC

  • In Home Supportive Care Agency
  • Waukon, IA
National Provider Identifier
1558191072
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
WAUKON IA SKILLED NURSING FACILITY, LLC
Practice address
960 4TH St NW
Waukon, IA 52172-1059
Phone
(563) 568-3493
NPI assigned
Aug 7, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Chaim Rajchenbach
Title
Principal
Phone
(847) 745-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

960 4TH St NW
Waukon, IA 52172-1059

Mailing address

960 4TH St NW
Waukon, IA 52172-1059

National Provider Directory

National Provider Directory
Tax ID family
Waukon Ia Skilled Nursing Facility LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

960 4th St NW
Waukon, IA 52172
Phone (563) 568-3493

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1558191072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 4TH ST NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521721059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 4TH ST NW",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521721059",
            "telephone_number": "563-568-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKON IA SKILLED NURSING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-745-7000"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.