Healthcare Provider Details

I. General information

NPI: 1760502694
Provider Name (Legal Business Name): CARRINGTON PLACE OF TOLEDO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 GRANDVIEW DR
TOLEDO IA
52342-2105
US

IV. Provider business mailing address

403 GRANDVIEW DR
TOLEDO IA
52342-2105
US

V. Phone/Fax

Practice location:
  • Phone: 641-484-5080
  • Fax:
Mailing address:
  • Phone: 641-484-5080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

# 1
Identifier0807255
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: BEN ATKINS
Title or Position: OWNER
Credential:
Phone: 727-723-3000