Healthcare Provider Details

I. General information

NPI: 1518184738
Provider Name (Legal Business Name): SIGOURNEY CARE CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S STONE ST
SIGOURNEY IA
52591-1202
US

IV. Provider business mailing address

900 S STONE ST
SIGOURNEY IA
52591-1202
US

V. Phone/Fax

Practice location:
  • Phone: 641-622-2971
  • Fax: 641-622-3165
Mailing address:
  • Phone: 641-622-2971
  • Fax: 641-622-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number540814
License Number StateIA

VIII. Authorized Official

Name: MR. DONALD L CHENSVOLD
Title or Position: MANAGER
Credential:
Phone: 319-362-8916