NPI | 1649242074 |
---|---|
Doing Business As | BLACKHAWK LIFE CARE CENTER |
Other Name | BLACK HAWK LIFE CARE CENTER |
Entity Type | Organization |
Authorized Contact | LINDA K. JUCKETTE President 515-223-6064 |
Organization Subpart ? | No |
Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA N-547) |
Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: IA 810547) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2022-01-11 |