Healthcare Provider Details

I. General information

NPI: 1790779809
Provider Name (Legal Business Name): WINFIELD HEALTH CARE & RETIREMENT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 W CENTRAL AVE
WINFIELD IA
52659-9768
US

IV. Provider business mailing address

706 W CENTRAL AVE
WINFIELD IA
52659-9768
US

V. Phone/Fax

Practice location:
  • Phone: 319-257-3303
  • Fax: 319-257-3270
Mailing address:
  • Phone: 319-257-3303
  • Fax: 319-257-3270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberI-235
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberI-235
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberI-235
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberI-235
License Number StateIA
# 5
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberI-235
License Number StateIA

VII. Legacy identifiers

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

# 1
Identifier0803932
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: KLAY W EDWARDS
Title or Position: PRESIDENT
Credential:
Phone: 319-257-3303