Healthcare Provider Details

I. General information

NPI: 1538150586
Provider Name (Legal Business Name): PRESBYTERIAN VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 10/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 BUTLER ST
ACKLEY IA
50601-1730
US

IV. Provider business mailing address

502 BUTLER ST
ACKLEY IA
50601-1730
US

V. Phone/Fax

Practice location:
  • Phone: 641-847-3531
  • Fax: 641-847-3428
Mailing address:
  • Phone: 641-847-3531
  • Fax: 641-847-3428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE HINDERS
Title or Position: CEO
Credential:
Phone: 641-847-3531