Healthcare Provider Details

I. General information

NPI: 1679703052
Provider Name (Legal Business Name): NLC PARTNERS, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 NORTHCREST DR
COUNCIL BLUFFS IA
51503-1622
US

IV. Provider business mailing address

2452 N BROADWAY
COUNCIL BLUFFS IA
51503-0434
US

V. Phone/Fax

Practice location:
  • Phone: 712-328-2333
  • Fax:
Mailing address:
  • Phone: 402-536-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number780853
License Number StateIA

VIII. Authorized Official

Name: STEVEN K. CHAMLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 402-536-0822