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NPI Code Detail

MEDICARE: MARJAN MANAGEMENT SERVICES LTD

MEDICARE: MARJAN MANAGEMENT SERVICES LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1313M00000XNursing Facility/Intermediate Care Facility720IA
2314000000XSkilled Nursing Facility720IA

General Provider Information

NPI Number : 1023005105
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARJAN MANAGEMENT SERVICES LTD
Provider Business Mailing Address
First Line : 6420 COUNCIL ST NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-1129
Country : US
Telephone Number : 319-393-1447
Fax Number : 319-378-9533
Provider Business Practice Location Address
First Line : 6420 COUNCIL ST NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-1129
Country : US
Telephone Number : 319-393-1447
Fax Number : 319-378-9533
Authorized Official
Title or Position : OWNER PRES ADMINISTRATOR
Name : MR. MARK DWIGHT TAGUE
Credential : NHA
Telephone Number : 319-393-1447
Provider Enumeration Date : 10/04/2005
Last Update Date : 12/28/2009

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Directions to “MARJAN MANAGEMENT SERVICES LTD ” Practice Location

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