Friendship Village Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N429 Issued in IA

Legal business name

FRIENDSHIP VILLAGE INC.

Practice address

600 Park LN
Waterloo, IA 50702-5200

Phone

(319) 291-8100

Fax

(319) 291-8324

NPI assigned

Feb 21, 2008

Organization subpart

No

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

Authorized official

Name

Lisa E Gates

Title

Cfo

Phone

(319) 291-8100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Skilled nursing facility certification: CCN 165081

Legal name

FRIENDSHIP VILLAGE INC.

Doing business as

FRIENDSHIP VILLAGE RETIREMENT CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 15, 1968

Last certification

Oct 9, 2024

Beds

72

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationProprietary

Enrollment address

580 Park LN
Waterloo, IA 50702-5291

Nursing home name

FRIENDSHIP VILLAGE RETIREMENT

Listed as

Friendship Village RetirementCCN 165081 · All quality measures

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Aug 15, 1968

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7265.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Friendship Village Inc2 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.

• Friendship Village Inc.

  • Assisted Living Facility
  • Waterloo, IA
  • NPI 1164089157
  NPD tax ID

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Pradeep Manjanbail Ramesh, MD

  • Internal Medicine Physician
  • Waterloo, IA
  • NPI 1053349167

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Tabetha Marie Gehrke, AGACNP

  • Acute Care Nurse Practitioner
  • Waterloo, IA
  • NPI 1588006928

  Nursing home

  Care Compare affiliation
• Nicole D Slater, ARNP

  • Nurse Practitioner
  • Waterloo, IA
  • NPI 1134580657

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1639348873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PARK LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025200",
            "telephone_number": "319-291-8100",
            "fax_number": "319-291-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PARK LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025200",
            "telephone_number": "319-291-8100",
            "fax_number": "319-291-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDSHIP VILLAGE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "319-291-8100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "N429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0801332",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert L Friedman, M.D.
• Thomas G Friedman, DDS
• Friends at Home
• Friends of Faith Retirement Homes, Inc. (Friendship Village)
• Friendship Village Inc.
• Eric Michael Frost, RN
• Alyssa Kay Fruchtenicht, LMSW
• Robert William Fuelling, D.C.
• Aralis Fuentes Martinez, MD
• Angela B Fuller, RN, PA-C

• Skilled Nursing Facility in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.