Black Hawk Nursing and Rehabilitation, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

BLACK HAWK NURSING AND REHABILITATION, LLC

Practice address

1410 W Dunkerton Rd
Waterloo, IA 50703-9648

Phone

(319) 291-2509

NPI assigned

Dec 26, 2018

Last updated

Sep 11, 2025By 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

Amira Krvavac

Title

Ar Director

Phone

(224) 470-2657

Specialties & licenses 1

Addresses

Tax ID family

Black Hawk Nursing and Rehabilitation LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Black Hawk Nursing and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Waterloo, IA
  • NPI 1285106567
  NPD tax ID
• Black Hawk Nursing and Rehabilitation, LLC

  • Mental Illness Intermediate Care Facility
  • Waterloo, IA
  • NPI 1538631817
  NPD tax ID

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1891267175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7366 N LINCOLN AVE STE 301",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121740",
            "telephone_number": "847-494-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HAWK NURSING AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KRVAVAC",
        "authorized_official_first_name": "AMIRA",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "224-470-2657"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blair J Birkett, TMLHC
• Patricia Jane Bischoff, ARNP
• Black Hawk Center for Independent Living (Prime Time Pass)
• Black Hawk Nursing and Rehabilitation, LLC
• Black Hawk Nursing and Rehabilitation, LLC
• Black Hawk-Grundy Mental Health Center Inc.
• Natalie Ann Bloom, ARNP, FNP-C
• Michael J Blough, DC
• Rachel Sue Blough
• Wayde Russell Blumhardt, CRNA

• Intellectual Disabilities Intermediate Care Facility in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Intellectual Disabilities Intermediate Care Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.