| NPI | 1891781399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A TIEMEYER Administrator 515-223-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA N-231) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-08-22 |