Healthcare Provider Details

I. General information

NPI: 1346214137
Provider Name (Legal Business Name): ABBEY OF LEMARS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 1ST AVE SE
LE MARS IA
51031-2043
US

IV. Provider business mailing address

320 1ST AVE SE
LE MARS IA
51031-2043
US

V. Phone/Fax

Practice location:
  • Phone: 712-546-7844
  • Fax: 712-546-9318
Mailing address:
  • Phone: 712-546-7844
  • Fax: 712-546-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number750489
License Number StateIA

VIII. Authorized Official

Name: MR. DON M BUTCHER
Title or Position: ADMINISTRATOR
Credential:
Phone: 712-546-7844