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

Active since June 14, 2005CLIA Certified · 2 labs
420 KENYON RD, FORT DODGE, IA 50501(515) 573-2121(515) 573-6045 Get Directions Write a Review

NPPES record last updated: January 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Friendship Haven, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRIENDSHIP HAVEN, INC (NPI 1114922481) is a healthcare organization registered as a skilled nursing facility in Fort Dodge, Iowa and active in the NPI registry since June 2005. The organization holds 2 active CLIA laboratory certificates and lists Kalleen Engels, Cfo, as its authorized official.

NPPES Registry Identity

NPI1114922481
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFRIENDSHIP HAVEN, INC
Location Address420 KENYON RDFort Dodge, IA 50501-5749
Mailing Address420 Kenyon RdFort Dodge, IA 50501-5749 · (515) 573-2121 · Fax (515) 573-6045
Fax(515) 573-6045
Organization SubpartNo
Authorized OfficialKalleen EngelsCfo · (515) 573-6018
Enumeration DateJune 14, 2005
Last NPPES UpdateJanuary 21, 2022
NPPES CertifiedJanuary 21, 2022
NPI 1114922481 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IA · 940037
Definition
(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.
Also ListedNursing Facility/Intermediate Care FacilityTaxonomy 313M00000X · License 940037 (IA)
420 KENYON RD, Fort Dodge, IA 50501

Other Identifiers 2

Medicaid175968IA
Medicaid801308IA

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D0384204

Friendship Haven · Fort Dodge, IA
Active · expires Jun 29, 2027
CLIA Number16D0384204
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 30, 2025
Certificate Expiration DateJune 29, 2027
Laboratory DirectorLincoln Wallace
Laboratory Phone(515) 573-2121
Laboratory LocationFriendship Haven420 Kenyon Road, Fort Dodge, IA 50501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2192738

Friendship Haven Assisted Living · Fort Dodge, IA
Active · expires Sep 13, 2026
CLIA Number16D2192738
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 14, 2024
Certificate Expiration DateSeptember 13, 2026
Laboratory DirectorCari A. Conrad
Laboratory Phone(515) 573-2121
Laboratory LocationFriendship Haven Assisted Living420 Kenyon Road, Fort Dodge, IA 50501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Friendship Haven, Inc's NPI number?

The NPI number for Friendship Haven, Inc is 1114922481. It was assigned to this organization in the NPPES registry on June 14, 2005.

Where is Friendship Haven, Inc located?

Friendship Haven, Inc is located at 420 Kenyon Rd, Fort Dodge, IA 50501. The listed phone number is (515) 573-2121.

What is Friendship Haven, Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Friendship Haven, Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Friendship Haven, Inc was last updated on January 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.