Signature Properties of Waukee, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SIGNATURE PROPERTIES OF WAUKEE, LLC

Doing business as

The Village at Legacy Pointe Nursing Facility

Practice address

1645 SE Holiday Crest Circle
Waukee, IA 50263

Phone

(515) 987-3625

NPI assigned

Apr 26, 2007

Last updated

Jun 27, 2008By 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

Mr. Bruce Henry Mehlhop, MA

Title

President and Managing Member

Phone

(515) 727-1770

Specialties & licenses 1

Addresses

Other names 1

• The Village at Legacy Pointe Nursing Facility Doing business as

Locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1891915245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 BIRCHWOOD CT",
            "address_2": "PO BOX 917",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312930",
            "telephone_number": "515-727-1770",
            "fax_number": "515-727-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 SE HOLIDAY CREST CIRCLE",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "50263",
            "telephone_number": "515-987-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE PROPERTIES OF WAUKEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "MEHLHOP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT AND MANAGING MEMBER",
        "authorized_official_telephone_number": "515-727-1770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Legacy Pointe Nursing Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.