Healthcare Provider Details

I. General information

NPI: 1558356386
Provider Name (Legal Business Name): TAMA HEALTH CARE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 HARDING ST
TAMA IA
52339-1028
US

IV. Provider business mailing address

1708 HARDING ST
TAMA IA
52339-1028
US

V. Phone/Fax

Practice location:
  • Phone: 641-484-4061
  • Fax: 641-484-3103
Mailing address:
  • Phone: 641-484-4061
  • Fax: 641-484-3103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DAVID LEE OSTHUS
Title or Position: MANAGING MEMBER
Credential:
Phone: 515-440-2177