Healthcare Provider Details

I. General information

NPI: 1245214584
Provider Name (Legal Business Name): GOOD SHEPHERD GERIATRIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 2ND ST NE
MASON CITY IA
50401-3412
US

IV. Provider business mailing address

302 2ND ST NE PO BOX 1707
MASON CITY IA
50401-3412
US

V. Phone/Fax

Practice location:
  • Phone: 641-424-1740
  • Fax: 641-424-4260
Mailing address:
  • Phone: 641-424-1740
  • Fax: 641-424-4260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number170219
License Number StateIA

VIII. Authorized Official

Name: MICHELLE HORST
Title or Position: CONTROLLER
Credential:
Phone: 641-424-1740