Healthcare Provider Details

I. General information

NPI: 1982479671
Provider Name (Legal Business Name): BELMOND IA SKILLED NURSING FACILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 7TH ST NE
BELMOND IA
50421-1604
US

IV. Provider business mailing address

1107 7TH ST NE
BELMOND IA
50421-1604
US

V. Phone/Fax

Practice location:
  • Phone: 641-444-3915
  • Fax:
Mailing address:
  • Phone: 641-444-3915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHAIM RAJCHENBACH
Title or Position: PRINCIPAL
Credential:
Phone: 847-745-7000