| NPI | 1104825876 |
|---|---|
| Doing Business As | COUNTRYSIDE RETIREMENT HOME, INC. |
| Entity Type | Organization |
| Authorized Contact | DEBBIE MENZENBERG Executive Director 712-276-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA N-0370) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: IA R-0370) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2009-09-11 |