| NPI | 1497741557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND F. POE Administrator 319-656-2421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 165470) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: IA 0891515) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2007-07-16 |