Healthcare Provider Details
I. General information
NPI: 1124141999
Provider Name (Legal Business Name): MANNING REGIONAL HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2007
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
402 MAIN ST
MANNING IA
51455-1033
US
IV. Provider business mailing address
402 MAIN ST
MANNING IA
51455-1033
US
V. Phone/Fax
- Phone: 712-655-2072
- Fax: 712-655-3330
- Phone: 712-655-2072
- Fax: 712-655-3330
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 313M00000X |
| Taxonomy | Nursing Facility/Intermediate Care Facility |
| License Number | 140058H |
| License Number State | IA |
VIII. Authorized Official
Name:
JOHN
OBRIEN
Title or Position: CEO
Credential:
Phone: 17126552072