NPIMap

Organization Active NPI

Life Extended Home LLC

  • Community/Behavioral Health Agency
  • Urbandale, IA
National Provider Identifier
1841012762
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFE EXTENDED HOME LLC
Practice address
5505 145TH Street
N/a
Urbandale, IA 50323
Phone
(515) 943-6732
NPI assigned
Oct 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Ntwari N Gakunzi
Title
Ceo
Phone
(515) 943-6732

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X Primary
Foster Care Agency 253J00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Addresses

Primary practice location

5505 145TH Street
N/a
Urbandale, IA 50323

Mailing address

5505 145TH Street
N/a
Urbandale, IA 50323
Phone (515) 943-6732

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1841012762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 145TH STREET",
            "address_2": "N/A",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "50323",
            "telephone_number": "515-943-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 145TH STREET",
            "address_2": "N/A",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "50323",
            "telephone_number": "515-943-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE EXTENDED HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "GAKUNZI",
        "authorized_official_first_name": "NTWARI",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-943-6732"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbandale, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.