Healthcare Provider Details

I. General information

NPI: 1982601688
Provider Name (Legal Business Name): ALBERT CITY IMPROVEMENT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 SPRUCE ST
ALBERT CITY IA
50510-1312
US

IV. Provider business mailing address

410 SPRUCE ST
ALBERT CITY IA
50510-1312
US

V. Phone/Fax

Practice location:
  • Phone: 712-843-2237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number110376
License Number StateIA

VIII. Authorized Official

Name: MAVIS L. LOVING
Title or Position: PRESIDENT
Credential:
Phone: 712-843-2237