Buena Vista Manor, Inc.

Primary specialty

Respite CareTaxonomy code 385H00000X

License

0478248 Issued in IA

Legal business name

BUENA VISTA MANOR, INC.

Doing business as

Buena Vista Manor

Practice address

1325 Lake Ave
Storm Lake, IA 50588-1907

Phone

(515) 223-6064

Fax

(515) 226-1244

NPI assigned

May 16, 2007

Last updated

Jul 15, 2011By 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. Kenneth D. Carlson

Title

General Manager

Phone

(515) 223-6064

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Buena Vista Manor Doing business as

Tax ID family

Buena Vista Manor2 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.

• Buena Vista Manor Care Center

  • Home Health Agency
  • Storm Lake, IA
  • NPI 1689894958
  NPD tax ID

Locations

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1740497403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 LAKE AVE",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881907",
            "telephone_number": "515-233-6064",
            "fax_number": "515-226-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 LAKE AVE",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505881907",
            "telephone_number": "515-223-6064",
            "fax_number": "515-226-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "515-223-6064",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "IA",
            "license": "0478248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0478248",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buena Vista Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Buena Vista Anesthesia Associates PLC
• Buena Vista County (Buena Vista County Public Health & Home Care)
• Buena Vista County
• Buena Vista County Community Services
• Buena Vista Manor Care Center
• Buena Vista Manor, Inc.
• Buena Vista Regional Medical Center (Buena Vista Regional Medical Center Homecare)
• Buena Vista Regional Medical Center
• Buena Vista Regional Medical Center
• Buena Vista Regional Medical Center

• Respite Care in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Respite Care in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.