Friends of Faith Retirement Homes, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0801332 Issued in IA

Legal business name

FRIENDS OF FAITH RETIREMENT HOMES, INC.

Doing business as

Friendship Village

Practice address

600 Park LN
Waterloo, IA 50702-5299

Phone

(319) 291-8100

Fax

(319) 291-8324

NPI assigned

Sep 14, 2006

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, NHA

Title

Executive Director

Phone

(319) 291-8100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Friendship Village Doing business as

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1790880383",
    "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": "507025299",
            "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": "507025299",
            "telephone_number": "319-291-8100",
            "fax_number": "319-291-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS OF FAITH RETIREMENT HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-291-8100",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": "0801332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0801332",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ericka Frey
• Michele L. Friedman, A.R.N.P.
• Robert L Friedman, M.D.
• Thomas G Friedman, DDS
• Friends at Home
• Friendship Village Inc.
• Friendship Village Inc.
• Eric Michael Frost, RN
• Alyssa Kay Fruchtenicht, LMSW
• Robert William Fuelling, D.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 Jun 29, 2015; 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.