| NPI | 1174519532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN MARIE ROGGE Administrator 712-376-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 180689) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: IA S0014) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2011-10-18 |