| NPI | 1811945520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A FOWLER Administration 515-955-4145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 0016) |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: IA 0016) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-08-22 |