PROFFITT'S RESIDENTIAL (NPI# 1750412672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750412672 |
| Entity Type | Organization |
| Organization Name | PROFFITT'S RESIDENTIAL |
| Practice Address |
615 West Washington St Centerville IA 52544-1623 |
| Mailing Address |
615 W Washington St Centerville IA 52544-1623 |
| Practice Telephone | 6418568344 |
| Practice Fax Number | 6414374161 |
| Mailing Telephone | 6418568344 |
| Mailing Fax Number | 6414374161 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY CATHERINE PROFFITT (OWNER) |
| Authorized Official Telephone | 6418568344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
R542 | IA | Nursing & Custodial Care Facilities |
| Street Address |
615 WEST WASHINGTON ST |
| City | CENTERVILLE |
| State | IA |
| Zip Code | 52544-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053651166 | Amy Spencer | Pharmacist | 609 N. 18th Street, Centerville, IA 52544 | 2013-02-26 |
| 1710253497 | Caregivers Home Health, LLC | Home Health | 19999 Saint Josephs Drive, Centerville, IA 52544 | 2012-03-28 |
| 1558529206 | Mercy Medical Center-centerville | Clinic/Center | 19876 St. Joseph's Drive, Centerville, IA 52544 | 2008-05-29 |
| 1205023868 | Mercy Medical Center-centerville | Home Health | 1 St. Joseph's Drive, Centerville, IA 52544 | 2007-09-27 |
| 1043414394 | Appanoose Community Care Services | Home Health | 19890 St. Joseph's Drive, Centerville, IA 52544 | 2007-06-12 |
| 1659591816 | The Continental At St. Joseph's | Assisted Living Facility | 19999 St. Joseph's Drive, Centerville, IA 52544 | 2007-04-27 |
| 1255456315 | Kirk & Gordy Associates, LLC | Clinic/Center | 415 and A Half North Haynes, Centerville, IA 52544 | 2007-03-20 |
| 1114087574 | New Focus Inc | Clinic/Center | 102 W Washington, New Focus Inc, Centerville, IA 52544 | 2006-12-08 |
| 1134169030 | Ron Michael Harshman | Dentist | 501 W Jackson St, Centerville, IA 52544 | 2006-06-08 |
| 1700835865 | State University of Iowa | Family Medicine | 19876 St. Joseph Drive, Centerville, IA 52544 | 2006-05-08 |
| Find all providers in zip 52544 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093006298 | Carol Care | Custodial Care Facility | 2214 Sycamore Hills Dr, Centerville, OH 45459-1286 | 2011-04-22 |
| 1194237222 | St Leonard | Custodial Care Facility | 8100 Clyo Rd, Centerville, OH 45458-2720 | 2017-10-30 |
| 1396087458 | Cape Head Injured Persons Housing and Education Group Inc | Custodial Care Facility | 9 Park Ave, Centerville, MA 02632-3430 | 2013-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033376603 | Country Living Care Center | Custodial Care Facility | 2840 K Ave, Toledo, IA 52342-9405 | 2008-05-20 |
| 1952510281 | Emeritus Properties II, Inc | Custodial Care Facility | 136 36th Avenue Sw, Cedar Rapids, IA 52404-4638 | 2007-05-22 |
| 1518086420 | Diamond Life Health Care, Inc. | Custodial Care Facility | 4912 Barnes City Rd, Montezuma, IA 50171-8544 | 2007-03-29 |
| 1871640144 | Legacy House LLC | Custodial Care Facility | 207 E Salem Ave, Indianola, IA 50125-2621 | 2007-01-05 |
| 1790842615 | Keokuk Area Group Home | Custodial Care Facility | 317 High St, Keokuk, IA 52632-5939 | 2007-01-02 |
| 1063578359 | Gbgb Lc Dba Briarwood Care Center | Custodial Care Facility | 416 S Clark St, Maquoketa, IA 52060-3226 | 2006-12-29 |
| 1285797415 | Comprehensive Systems, Inc | Custodial Care Facility | 818 N 7th St, Osage, IA 50461-1360 | 2006-12-19 |
| 1679636740 | Comprehensive Systems, Inc. | Custodial Care Facility | 841 W Main St, New Hampton, IA 50659-1005 | 2006-12-19 |
| 1780747915 | Comprehensive Systems, Inc | Custodial Care Facility | 702 Elm Street, Elma, IA 50628 | 2006-12-19 |
| 1144383464 | Comprehensive Systems, Inc | Custodial Care Facility | 695 S Illinois Ave, Mason City, IA 50401-5405 | 2006-12-18 |
| Find all providers with the same taxonomy | ||||
| City | CENTERVILLE |
| Zip Code | 52544 |
Please comment or provide details below to improve the information on PROFFITT'S RESIDENTIAL.
| 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.