Healthcare Provider Details

I. General information

NPI: 1912921198
Provider Name (Legal Business Name): MARIAN HEALTH CENTER-SMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 5TH ST
SIOUX CITY IA
51101-1326
US

IV. Provider business mailing address

801 5TH ST
SIOUX CITY IA
51101-1326
US

V. Phone/Fax

Practice location:
  • Phone: 712-279-2010
  • Fax: 712-279-5631
Mailing address:
  • Phone: 712-279-2010
  • Fax: 712-279-5631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number970112H
License Number StateIA

VIII. Authorized Official

Name: JESICA HANSON
Title or Position: VP FINANCE
Credential:
Phone: 712-279-5850