Centers for Long Term Care of Iowa, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CENTERS FOR LONG TERM CARE OF IOWA, INC

Doing business as

CLC Altoona

Practice address

200 7TH Ave SW
Altoona, IA 50009-1630

Phone

(515) 967-4267

Fax

(515) 967-7459

NPI assigned

Mar 20, 2006

Last updated

Aug 22, 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

Gary R Trebert

Title

Ceo

Phone

(817) 359-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CLC Altoona Doing business as

Tax ID family

Arbor Heights at University2 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.

• Pinnacle Health Facilities Xvii LP

  dba Arbor Heights at University

  • Assisted Living Facility
  • Des Moines, IA
  • NPI 1245699214
  NPD tax ID

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841259702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155635",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761550635",
            "telephone_number": "817-359-2000",
            "fax_number": "817-359-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 7TH AVE SW",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500091630",
            "telephone_number": "515-967-4267",
            "fax_number": "515-967-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS FOR LONG TERM CARE OF IOWA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREBERT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-359-2000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0654269",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLC Altoona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacob Anthony Campese
• Zoe Carnes
• Kimberly Caseley, HIS
• Lizbeth Cayetano, RBT
• CCRC of Altoona LLC (Prairie Vista Village)
• Central Iowa Hospital Corporation (Altoona Family Care Center)
• Samantha Cermak, BCBA
• Tena Paul Chau, DNP, FNP-C
• Christensen Chiropractic PC
• Jeffery Tate Christensen, DC

• Skilled Nursing Facility in Altoona, IA
• Providers in Altoona, 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 Aug 22, 2020; 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.