FRIENDSHIP HAVEN, INC
NPI 1114922481
Skilled Nursing Facility in Fort Dodge, IA

NPI Status: Active since June 14, 2005

Contact Information

420 KENYON RD
FORT DODGE, IA
ZIP 50501
Phone: (515) 573-2121
Fax: (515) 573-6045

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  • Organization
  • Skilled Nursing Facility
  • Accepts Insurance
  • CLIA Number: 16D0384204
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 06-29-2025

About FRIENDSHIP HAVEN, INC

This page provides the complete NPI Profile along with additional information for Friendship Haven, Inc, a provider established in Fort Dodge, Iowa operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1114922481 assigned on June 2005. The practitioner's primary taxonomy code is 314000000X with license number 940037 (IA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Kalleen Engels (Cfo)

NPI
1114922481
Provider Name
FRIENDSHIP HAVEN, INC
Entity Type
Organization
Location Address
420 KENYON RD FORT DODGE, IA 50501
Location Phone
(515) 573-2121
Location Fax
(515) 573-6045
Mailing Address
420 KENYON RD FORT DODGE, IA 50501
Mailing Phone
(515) 573-2121
Mailing Fax
(515) 573-6045
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-14-2005
Last Update Date
01-21-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
940037
License State
IA
Taxonomy Description
(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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1313M00000XNursing & Custodial Care Facilities

Nursing Facility/Intermediate Care Facility

940037 (IA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Wellmark Bronze HDHP HMO HSA Qualified - HMO
  • Wellmark Bronze Standard | UnityPoint Health - HMO
  • Wellmark Bronze Traditional HMO - HMO
  • Wellmark Gold Primary Care | UnityPoint Health - HMO
  • Wellmark Gold Traditional HMO - HMO
  • Wellmark Silver Primary Care | UnityPoint Health - HMO
  • Wellmark Silver Traditional HMO - HMO
  • Wellmark Standard Bronze HMO - HMO
  • Wellmark Standard Gold HMO - HMO
  • Wellmark Standard Silver HMO - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KALLEEN ENGELS

Authorized Official Title
CFO
Authorized Official Phone
(515) 573-6018

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
175968MEDICAID (05)IA 
801308MEDICAID (05)IA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
16D0384204
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
June 30, 2023
Certificate Expiration Date
June 29, 2025
Laboratory Director
LINCOLN WALLACE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Friendship Haven, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for FRIENDSHIP HAVEN, INC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1114922481
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21241824416
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 1 + 8 + 2 + 4 + 4 + 1 + 6 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1114922481 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1598966814 ROSE MONSON PTA
Individual
Physical Therapy Assistant420 KENYON RD
FORT DODGE, IA 50501
(615) 896-6400
1700809407FRIENDSHIP HAVEN PHARMACY
Organization
Pharmacy (Long Term Care Pharmacy)420 KENYON RD
FORT DODGE, IA 50501
(515) 573-6015
1457637894NORTH CENTRAL IOWA MENTAL HEALTH CENTER, INC
Organization
Clinic/Center (Mental Health (Including Community Mental Health Center))420 KENYON RD
FORT DODGE, IA 50501
(515) 573-2121

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114922481, enumerated in the NPI registry as an "organization" on June 14, 2005

The provider is located at 420 Kenyon Rd Fort Dodge, Ia 50501 and the phone number is (515) 573-2121

This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X

The provider might be accepting Accepts: Wellmark Health Plan of Iowa, Inc., Medicare and. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 16D0384204 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 14, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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