| NPI | 1023005105 |
|---|---|
| Doing Business As | NORTHBROOK MANOR CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | MARK DWIGHT TAGUE Owner Pres Administrator 319-393-1447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 720) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA 720) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2009-12-28 |