Healthcare Provider Details

I. General information

NPI: 1285777847
Provider Name (Legal Business Name): TRAER NURSING CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 6TH ST
TRAER IA
50675-1311
US

IV. Provider business mailing address

909 6TH ST
TRAER IA
50675-1311
US

V. Phone/Fax

Practice location:
  • Phone: 319-478-2730
  • Fax: 319-478-2728
Mailing address:
  • Phone: 319-478-2730
  • Fax: 319-478-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number860226
License Number StateIA

VIII. Authorized Official

Name: STANLEY F HLADIK
Title or Position: PRESIDENT
Credential:
Phone: 319-478-2730