| NPI | 1922091552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY LYNN HANSON Administrator 319-442-3234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IA 160604) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA N263) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2018-09-11 |