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General NPI Number Information
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NPI Number | 1326804980
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Entity Type | Organization
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Legal Business Name | AL OF ASPEN HEIGHTS, INC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 1410 ASPEN ST
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City | HULL
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State | IA
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Zip | 51239
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Country | US
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Telephone | 712-439-6715
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Fax | 712-439-6717
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Provider Business Mailing Address
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Address Line | 1410 ASPEN ST
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City | HULL
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State | IA
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Zip | 51239
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Country | US
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Telephone | 712-439-6715
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Fax | 712-439-6717
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARK HOLTKAMP
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Credential |
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Telephone | 319-594-1062
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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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