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General NPI Number Information
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NPI Number | 1063856771
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Entity Type | Organization
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Legal Business Name | THE ROSE OF EAST DES MOINES, L.P.
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 1331 IDAHO ST
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City | DES MOINES
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State | IA
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Zip | 50316-2463
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Country | US
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Telephone | 515-883-1000
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Fax | 515-266-0116
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Provider Business Mailing Address
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Address Line | 16670 FRANKLIN TRL SE
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City | PRIOR LAKE
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State | MN
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Zip | 55372-2927
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Country | US
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Telephone | 952-447-2345
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Fax | 952-447-2344
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Authorized Official
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Title or Position | PRESIDENT OF GENERAL PARTNER
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Name | MR. GREGORY A MCCLENAHAN
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Credential | J.D.
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Telephone | 952-447-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | IA
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