Spirit Lake Senior Operator, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SPIRIT LAKE SENIOR OPERATOR, LLC

Doing business as

Keelson Harbour Senior Living

Practice address

2810 Aurora Ave
Spirit Lake, IA 51360-7055

Phone

(712) 336-4501

Fax

(712) 336-4509

NPI assigned

Feb 5, 2020

Last updated

Feb 5, 2020By 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

Melissa Sewell

Title

Assistant Manager

Phone

(712) 336-4501

Specialties & licenses 1

Addresses

Other names 1

• Keelson Harbour Senior Living 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": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1740812072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 AURORA AVE",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513607055",
            "telephone_number": "712-336-4501",
            "fax_number": "712-336-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 AURORA AVE",
            "city": "SPIRIT LAKE",
            "state": "IA",
            "postal_code": "513607055",
            "telephone_number": "712-336-4501",
            "fax_number": "712-336-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT LAKE SENIOR OPERATOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "712-336-4501"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keelson Harbour Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gavin Sorensen
• Mark Steven Sorensen, HIS
• Spencer Municipal Hospital (Warner Dialysis Center- Spirit Lake)
• Spirit Lake C.S.D.
• Spirit Lake Chiropractic Clinic
• St Croix Hospice LLC (St. Croix Hospice)
• Nicole Marie Stall, NP-C
• Paige Nicole Steffen Frick, DC
• Steven a Moore
• Still Waters Therapy

• Assisted Living Facility in Spirit Lake, IA
• Providers in Spirit Lake, IA by specialty
• Assisted Living Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.