Healthcare Provider Details

I. General information

NPI: 1558292607
Provider Name (Legal Business Name): 455 SW ANKENY ROAD OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SW ANKENY RD
ANKENY IA
50023-9728
US

IV. Provider business mailing address

4500 DORR ST
TOLEDO OH
43615-4040
US

V. Phone/Fax

Practice location:
  • Phone: 515-238-9005
  • Fax: 515-777-3227
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SHARON MAKOWSKY
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 419-247-2800