Healthcare Provider Details

I. General information

NPI: 1629695416
Provider Name (Legal Business Name): ACCURA HEALTHCARE OF SHENANDOAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S ELM ST
SHENANDOAH IA
51601-2221
US

IV. Provider business mailing address

1370 NW 114TH ST STE 100
CLIVE IA
50325-7008
US

V. Phone/Fax

Practice location:
  • Phone: 712-246-4627
  • Fax:
Mailing address:
  • Phone: 515-421-4878
  • Fax: 515-963-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: TED LENEAVE
Title or Position: PRESIDENT
Credential:
Phone: 515-421-4878