WAVERLEY - CASA DE PAZ, INC. (NPI# 1770577405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770577405 |
| Entity Type | Organization |
| Organization Name | WAVERLEY - CASA DE PAZ, INC. |
| Other Organization Name | CASA DE PAZ HEALTH CARE CENTER |
| Practice Address |
2121 W 19th St Sioux City IA 51103-2333 |
| Practice Telephone | 7122333127 |
| Practice Fax Number | 7122331177 |
| Mailing Telephone | 7122333127 |
| Mailing Fax Number | 7122581177 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2008-09-16 |
| Authorized Official Name | MR. CHAUNCEY R. DUNBAR (SECRETARY / TREASURER) |
| Authorized Official Telephone | 6019561576 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 0474718 | IA | Suppliers |
| Y | 314000000X | Skilled Nursing Facility | 970125 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | DME | 0474718 | 01 |
| IA | PART B SUPPLIER NUMBER | 0609950001 | 01 |
| IA | 0806919 | 05 |
| Other Name | Type Code |
|---|---|
| Casa de Paz Health Care Center | Doing Business As Name - Organization |
| Street Address |
2121 W 19TH ST |
| City | SIOUX CITY |
| State | IA |
| Zip Code | 51103-2333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811353519 | Premier Estates 510, LLC | Skilled Nursing Facility | 2121 W 19th St, Sioux City, IA 51103-2333 | 2016-01-11 |
| 1841495322 | William Odes Welcher | Physical Therapy Assistant | 2121 W 19th St, Sioux City, IA 51103-2333 | 2007-06-15 |
| 1225232135 | Angela Lee Britt | Occupational Therapist | 2121 W 19th St, Sioux City, IA 51103-2333 | 2007-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770966491 | Jackson Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 3500 West 4th Street, Sioux City, IA 51103 | 2015-06-30 |
| 1740685361 | Juliet Emerald Brinkman | Registered Nurse | Unity Point, Siouxland Pace- 1200 Tri View Ave, Sioux City, IA 51103 | 2014-10-24 |
| 1295197374 | Jamaine Wamberg | Counselor | 3320 W 4th St, Sioux City, IA 51103 | 2016-03-28 |
| 1477789311 | Amy Christine Bloch | Social Worker | 1601 Military Road, Sioux City, IA 51103 | 2009-06-05 |
| 1891755906 | Julie A. Elbert | Social Worker | 1601 Military Road, Sioux City, IA 51103 | 2006-03-23 |
| 1497720544 | Rhonda Jane Brown | Counselor | 1601 Military Road, Sioux City, IA 51103 | 2006-02-22 |
| 1235332123 | Lunchtime Solutions, Inc. | Home Delivered Meals | 3100 West Fourth Street, Sioux City, IA 51103-0100 | 2007-06-07 |
| 1871938738 | Lisa Marie Theisen | Specialist | 3090 Rebecca St, Sioux City, IA 51103-1458 | 2013-05-06 |
| 1013146315 | Lee and Associates Consultants LLC | Social Worker | 1608 Casselman, Sioux City, IA 51103-1628 | 2009-07-08 |
| 1508855271 | Holy Spirit Retirement Home Inc | Skilled Nursing Facility | 1701 W 25th St, Sioux City, IA 51103-1705 | 2005-10-17 |
| Find all providers in zip 51103 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346763554 | Mercy Health Services - Iowa Corp | Skilled Nursing Facility | 801 5th St Fl 7, Sioux City, IA 51101 | 2017-07-19 |
| 1740428366 | Touchstone Living Center, LLC | Skilled Nursing Facility | 1800 Indian Hills Dr, Sioux City, IA 51104-1518 | 2009-02-04 |
| 1407817653 | Hallmark Care LLC | Skilled Nursing Facility | 3800 Indian Hills Dr, Sioux City, IA 51104-1620 | 2006-03-29 |
| 1396718458 | Care Initiatives | Skilled Nursing Facility | 4201 Fieldcrest Dr, Sioux City, IA 51103-3184 | 2006-02-09 |
| 1720064843 | Harvest Communities of Sioux City, Inc | Skilled Nursing Facility | 3420 Old Lakeport Rd, Sioux City, IA 51106 | 2005-12-20 |
| 1508855271 | Holy Spirit Retirement Home Inc | Skilled Nursing Facility | 1701 W 25th St, Sioux City, IA 51103-1705 | 2005-10-17 |
| 1568926053 | Indian Hills Health Care of Sioux City, LLC | Skilled Nursing Facility | 1800 Indian Hills Dr, Sioux City, IA 51104-1518 | 2019-01-29 |
| 1811353519 | Premier Estates 510, LLC | Skilled Nursing Facility | 2121 W 19th St, Sioux City, IA 51103-2333 | 2016-01-11 |
| 1649642976 | Countryside Health Investors LLC | Skilled Nursing Facility | 6120 Morningside Ave, Sioux City, IA 51106-3943 | 2015-10-26 |
| 1245658483 | Pcnr, LLC | Skilled Nursing Facility | 6120 Morningside Ave, Sioux City, IA 51106-3943 | 2014-04-04 |
| Find all providers in SIOUX CITY | ||||
| City | SIOUX CITY |
| Zip Code | 51103 |
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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.