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APPLE VALLEY ASSISTED LIVING LLC. NPI 1508085879


NPI Information

NPI: 1508085879
Provider Name: APPLE VALLEY ASSISTED LIVING LLC.
Classification: Point of Service - 305S00000X
Entity Type: Organization

CLIA Number: 16D1057376

Address:
405 27TH AVE S
CLEAR LAKE, IA
ZIP 50428
Phone: (641) 357-7083
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APPLE VALLEY ASSISTED LIVING LLC. is a point of service in Clear Lake, IA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. APPLE VALLEY ASSISTED LIVING LLC. NPI is 1508085879. The provider is registered as an organization entity type.

The provider's business location address is:

405 27TH AVE S
CLEAR LAKE, IA
ZIP 50428-002
Phone: (641) 357-7083
Fax: (641) 357-1512

The provider's authorized official is Terri Ann Cosselman .
The authorized official title is Administrator and has the following contact phone number (641) 357-7083.

The CLIA number assigned to this NPI record is 16D1057376 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of ServiceS0166IOWAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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