Provider Demographics
NPI:1285638148
Name:AASE HAUGEN HOMES, INC.
Entity Type:Organization
Organization Name:AASE HAUGEN HOMES, INC.
Other - Org Name:AASE HAUGEN SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DORI
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-382-3603
Mailing Address - Street 1:4 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-1516
Mailing Address - Country:US
Mailing Address - Phone:563-382-3603
Mailing Address - Fax:
Practice Address - Street 1:4 OHIO ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-1516
Practice Address - Country:US
Practice Address - Phone:563-382-3603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0115584310400000X
IAR338311Z00000X
IA960338314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA65178OtherWELLMARK NUMBER
IA960338OtherSNF LICENSE NUMBER
IA0115584OtherWAIVER NUMBER
IAR338OtherRCF LICENSE NUMBER
IA0892315Medicaid
IA0115584OtherASSISTED LIVING LICENSE
IA0800003Medicaid
IA0800003Medicaid