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General NPI Number Information
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NPI Number | 1134149529
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Entity Type | Organization
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Legal Business Name | RISEN SON CHRISTIAN VILLAGE
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3000 RISEN SON BLVD
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-1911
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Country | US
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Telephone | 712-366-9655
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Fax | 712-366-4748
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Provider Business Mailing Address
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Address Line | 3000 RISEN SON BLVD
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-1911
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Country | US
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Telephone | 712-366-9655
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Fax | 712-366-4748
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Authorized Official
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Title or Position | CONTROLLER
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Name | MRS. SUSAN MCGHEE
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Credential |
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Telephone | 217-732-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 780641
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 780641
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 780641
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License Number State | IA
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