Healthcare Provider Details
I. General information
NPI: 1518732205
Provider Name (Legal Business Name): SIGOURNEY IA SKILLED NURSING FACILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1212 S STUART ST
SIGOURNEY IA
52591-1307
US
IV. Provider business mailing address
1212 S STUART ST
SIGOURNEY IA
52591-1307
US
V. Phone/Fax
- Phone: 641-622-2142
- Fax:
- Phone: 641-622-2142
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHAIM
RAJCHENBACH
Title or Position: PRINCIPAL
Credential:
Phone: 847-745-7000