STORY COUNTY COMMUNITY LIFE PROGRAM (NPI# 1740352467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740352467 |
| Entity Type | Organization |
| Organization Name | STORY COUNTY COMMUNITY LIFE PROGRAM |
| Practice Address |
104 S Hazel Ave Ames IA 50010-5952 |
| Practice Telephone | 5159562600 |
| Practice Fax Number | 5159562609 |
| Mailing Telephone | 5159562600 |
| Mailing Fax Number | 5159562609 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. GAYLA R HARKEN (DIRECTOR) |
| Authorized Official Telephone | 5159562600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0115717 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164597340 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 124 S Hazel Ave, Ames, IA 50010-5952 | 2006-11-22 |
| 1366516114 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 620 Duluth St, Ames, IA 50010-8558 | 2006-11-20 |
| 1902970759 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3911 Calhoun Ave, Ames, IA 50010-4164 | 2006-11-20 |
| 1689986887 | Story County Community Life Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 S Hazel Ave, Ames, IA 50010-5952 | 2010-07-06 |
| 1851526586 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 S Hazel Ave, Ames, IA 50010-5952 | 2009-05-26 |
| 1477727204 | Story County Community Life Program | Community/Behavioral Health | 104 S Hazel Ave, Ames, IA 50010-5952 | 2008-04-14 |
| 1902024755 | Story County Community Life Program | Community/Behavioral Health | 104 S Hazel Ave, Ames, IA 50010-5952 | 2007-04-24 |
| Street Address |
104 S HAZEL AVE |
| City | AMES |
| State | IA |
| Zip Code | 50010-5952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689986887 | Story County Community Life Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 S Hazel Ave, Ames, IA 50010-5952 | 2010-07-06 |
| 1851526586 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 S Hazel Ave, Ames, IA 50010-5952 | 2009-05-26 |
| 1477727204 | Story County Community Life Program | Community/Behavioral Health | 104 S Hazel Ave, Ames, IA 50010-5952 | 2008-04-14 |
| 1902024755 | Story County Community Life Program | Community/Behavioral Health | 104 S Hazel Ave, Ames, IA 50010-5952 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851853063 | Eric Martin Mills | Social Worker | 320 South 17th Street, Ames, IA 50010 | 2019-04-05 |
| 1487147963 | Mcfarland Clinic, PC | Eyewear Supplier (Equipment, not the service) | 3500 University Blvd., Suite 1001, Ames, IA 50010 | 2018-06-11 |
| 1346733763 | Katelyn Elaine Holbrook | Occupational Therapist | 1915 Philadelphia Street, Ames, IA 50010 | 2018-06-11 |
| 1174030571 | Joshua B Hubbell | Peer Specialist | 527 E Lincoln Way #216, Ames, IA 50010 | 2018-01-08 |
| 1528426996 | Brandy Suzanne Walker | Occupational Therapist | 28201 550th Ave, Ames, IA 50010 | 2016-02-01 |
| 1386086338 | Adrienne Rae Shrader | Counselor | 600 5th Street, Suite 200, Ames, IA 50010 | 2013-07-18 |
| 1164708509 | North Central Iowa Mental Health Center Inc | Clinic/Center | 1801 20th St, Ames, IA 50010 | 2011-10-31 |
| 1669752226 | Ashley Rae Loeffelholz | Pharmacist | Nucara Pharmacy #28, 3600 University Blvd Suite 103, Ames, IA 50010 | 2011-08-26 |
| 1245544436 | Crawford Endodontics, Pllc | Dentist | 515 Grand Ave., Suite 102, Ames, IA 50010 | 2010-07-30 |
| 1023256708 | Donald Warren Powers | Family Medicine | 2538 Eisenhower, Ames, IA 50010 | 2009-02-03 |
| Find all providers in zip 50010 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164597340 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 124 S Hazel Ave, Ames, IA 50010-5952 | 2006-11-22 |
| 1366516114 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 620 Duluth St, Ames, IA 50010-8558 | 2006-11-20 |
| 1902970759 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3911 Calhoun Ave, Ames, IA 50010-4164 | 2006-11-20 |
| 1851526586 | Story County Community Life Program | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 104 S Hazel Ave, Ames, IA 50010-5952 | 2009-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750696852 | Community Neurorehab of Iowa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3000 Sw 37th St, Des Moines, IA 50321-1330 | 2010-08-12 |
| 1437325693 | Nishna Productions, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 304 W Valley Ave, Shenandoah, IA 51601-1218 | 2008-05-07 |
| 1184890477 | Nishna Productions, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 100 E Oak St, Red Oak, IA 51566-1544 | 2008-05-06 |
| 1881890788 | Hope Haven Cottonwood | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 910 Cottonwood Ct Ste 1002, Burlington, IA 52601-1994 | 2007-06-26 |
| 1629293527 | Marion County Care Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1111 Newbold St, Knoxville, IA 50138-8605 | 2007-04-16 |
| 1407070808 | Country Care Center, Corp | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 725 Highway 59, Harlan, IA 51537-6709 | 2007-04-13 |
| 1144354614 | Hope Haven Area Development Center Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2205 Northern Dr, Burlington, IA 52601-2256 | 2007-03-15 |
| 1851425748 | Hope Haven Area Development Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2209 Northern Dr, Burlington, IA 52601-2256 | 2007-03-15 |
| 1598893406 | Systems Unlimited, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2553 Scott Blvd Se, Iowa City, IA 52240 | 2007-03-01 |
| 1841327673 | Crossroads of Western Iowa | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Crossroads Pl, Missouri Valley, IA 51555-6069 | 2007-02-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.