Crest Haven Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

880066 Issued in IA

Legal business name

CREST HAVEN CARE CENTER, LLC

Doing business as

Crest Haven Care Centre

Practice address

1000 E Howard St
Creston, IA 50801-2723

Phone

(641) 782-5012

Fax

(641) 782-5309

NPI assigned

Apr 6, 2006

Last updated

Jun 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory S Bench

Title

Authorized Representative

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Crest Haven Care Centre Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1710940358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11523 PALMBRUSH TRL",
            "address_2": "SUITE 331",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342022917",
            "telephone_number": "941-758-4745",
            "fax_number": "888-391-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E HOWARD ST",
            "city": "CRESTON",
            "state": "IA",
            "postal_code": "508012723",
            "telephone_number": "641-782-5012",
            "fax_number": "641-782-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST HAVEN CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "941-758-4745",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "880066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800080",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800425",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0236984",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crest Haven Care Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caitlyn Cooper, CNA
• Sheena Katherine Cortner, PA-C
• Jessica Crandall, ARNP - FNP
• Lauren Craver
• Creative Minds
• Crest Pharmacy, Inc
• Creston Chiropractic, P.C.
• Creston Community School District
• Creston Medical Clinic, P.C.
• Creston Medical Clinic, P.C.

• Skilled Nursing Facility in Creston, IA
• Providers in Creston, 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 Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.