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ROCK OF AGES HOME INC
NPI 1609945005
Assisted Living Facility in Jamestown, ND

Active since November 07, 2006CLIA 35D0408739 · Waiver
1315 4TH ST NE, JAMESTOWN, ND 58401(701) 252-9292(701) 252-0417 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rock Of Ages Home Inc NPPES

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

ROCK OF AGES HOME INC (NPI 1609945005) is a healthcare organization registered as an assisted living facility in Jamestown, North Dakota and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through July 28, 2027 and lists Tim M Exner, Administrator Owner, as its authorized official.

NPPES Registry Identity

NPI1609945005
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameROCK OF AGES HOME INC
Location Address1315 4TH ST NEJamestown, ND 58401-3726
Mailing Address1315 4th St NeJamestown, ND 58401-3726 · (701) 252-9292 · Fax (701) 252-0417
Phone(701) 252-9292
Fax(701) 252-0417
Organization SubpartNo
Authorized OfficialTim M ExnerAdministrator Owner · (701) 252-9292
Enumeration DateNovember 7, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1609945005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in ND · 8021B
Definition
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.
1315 4TH ST NE, Jamestown, ND 58401
Open in Google Maps ↗

Other Identifiers 1

Medicaid30716ND

CLIA Laboratory Certificates CMS CLIA

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 35D0408739

Rock Of Ages · Jamestown, ND
Active · expires Jul 28, 2027
CLIA Number35D0408739
Laboratory TypeOther
Certificate Effective DateJuly 29, 2025
Certificate Expiration DateJuly 28, 2027
Laboratory DirectorJordan Shipley
Laboratory Phone(701) 252-9292
Laboratory LocationRock Of Ages1315 4th Street NE, Jamestown, ND 58401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Rock Of Ages Home Inc's NPI number?

The NPI number for Rock Of Ages Home Inc is 1609945005. It was assigned to this organization in the NPPES registry on November 7, 2006.

Where is Rock Of Ages Home Inc located?

Rock Of Ages Home Inc is located at 1315 4th St NE, Jamestown, ND 58401. The listed phone number is (701) 252-9292.

What is Rock Of Ages Home Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Rock Of Ages Home Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D0408739) is associated with this NPI, valid through July 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rock Of Ages Home Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.