NPIMap

Organization Active NPI

Handicap Village

Doing business as Opportunity Village

  • Intellectual Disabilities Intermediate Care Facility
  • Fort Dodge, IA
National Provider Identifier
1669709622
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
HANDICAP VILLAGE
Doing business as
Opportunity Village
Practice address
1470 21St Ave N
Fort Dodge, IA 50501-7114
Phone
(515) 573-8243
Fax
(515) 576-4269
NPI assigned
Nov 12, 2009
Last updated
Nov 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Mr. John Severtson
Title
Ceo
Phone
(641) 357-5277

Specialties & licenses 1

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

Addresses

Primary practice location

1470 21St Ave N
Fort Dodge, IA 50501-7114

Mailing address

PO Box 622
Clear Lake, IA 50428-0622
Phone (641) 357-5277

Other names 1

  • Opportunity Village Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Handicap Village24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1669709622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 622",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "504280622",
            "telephone_number": "641-357-5277",
            "fax_number": "641-357-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 21ST AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505017114",
            "telephone_number": "515-573-8243",
            "fax_number": "515-576-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANDICAP VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "SEVERTSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "641-357-5277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Opportunity Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.