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General NPI Number Information
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NPI Number | 1154280873
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Entity Type | Organization
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Legal Business Name | CAMANCHE 1, LLC DBA PARK VISTA RETIREMENT LIVING-CAMANCHE
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 1810 PARK VISTA DR
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City | CAMANCHE
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State | IA
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Zip | 52730-9504
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Country | US
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Telephone | 563-447-7447
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Fax | 563-321-4849
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Provider Business Mailing Address
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Address Line | 1810 PARK VISTA DR
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City | CAMANCHE
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State | IA
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Zip | 52730-9504
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Country | US
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Telephone | 563-447-7447
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Fax | 563-321-4849
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | KELLEY ANN ROBINSON-KLOTZBUECHER
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Credential | RN
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Telephone | 715-281-4515
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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 |
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