COUNTRY MEADOW PLACE LLC NPI 1912076332

NPI Information

  • NPI: 1912076332
  • Provider Name: COUNTRY MEADOW PLACE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Former Legal Business Name: WILLOW POINTE RESIDENCES LLC
  • CLIA Number: 16D1061185
  • Address: 17396 KINGBIRD AVE
    MASON CITY, IA
    ZIP 50401
  • Phone: (641) 423-7722

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NPI Details

COUNTRY MEADOW PLACE LLC is an assisted living facility in Mason City, IA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. COUNTRY MEADOW PLACE LLC NPI is 1912076332. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Willow Pointe Residences Llc.

The provider's business location address is:

17396 KINGBIRD AVE
MASON CITY, IA
ZIP 50401-251
Phone: (641) 423-7722

The provider's authorized official is Nicole Bown .
The authorized official title is Controller and has the following contact phone number (319) 363-6105.

The CLIA number assigned to this NPI record is 16D1061185 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 12/26/2013.

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
1310400000XAssisted Living FacilityS0004IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10158840MEDICAIDIOWA

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: 11/21/2025

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