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
  • CLIA Number: 16D0384204
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 06-29-2027

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:

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, 2025
Certificate Expiration Date
June 29, 2027
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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114922481, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 9 → 18 → 9 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 1 + 8 + 2 + 4 + 4 + 1 + 6 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1114922481.

Other Providers at the Same Location


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

Physical Therapy Assistant
420 KENYON RD
FORT DODGE, IA 50501
Clinic/Center (Mental Health (Including Community Mental Health Center))
420 KENYON RD
FORT DODGE, IA 50501
Pharmacy (Long Term Care Pharmacy)
420 KENYON RD
FORT DODGE, IA 50501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114922481, enumerated 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.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.