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General NPI Number Information
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NPI Number | 1356291546
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Entity Type | Organization
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Legal Business Name | WAUKON IA SKILLED NURSING FACILITY, LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 602 2ND ST SW
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City | WAUKON
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State | IA
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Zip | 52172-2242
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Country | US
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Telephone | 563-568-4207
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Fax |
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Provider Business Mailing Address
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Address Line | 602 2ND ST SW
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City | WAUKON
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State | IA
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Zip | 52172-2242
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MENACHEM SHABAT
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Credential |
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Telephone | 847-679-5331
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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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