Healthcare Provider Details

I. General information

NPI: 1750377859
Provider Name (Legal Business Name): CAREAGE HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N 2ND ST
CHEROKEE IA
51012-1229
US

IV. Provider business mailing address

725 N 2ND ST
CHEROKEE IA
51012-1229
US

V. Phone/Fax

Practice location:
  • Phone: 712-225-2561
  • Fax: 712-225-5350
Mailing address:
  • Phone: 712-225-2561
  • Fax: 712-225-5350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number180063
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. MARILYN M. PECK
Title or Position: ADMINISTRATOR
Credential:
Phone: 712-225-2561