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General NPI Number Information
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NPI Number | 1528051901
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Entity Type | Organization
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Legal Business Name | LUTHERAN RETIREMENT HOME, INC.
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 701 9TH ST N
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City | NORTHWOOD
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State | IA
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Zip | 50459-1004
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Country | US
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Telephone | 641-324-1712
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Fax | 641-324-3091
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Provider Business Mailing Address
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Address Line | 701 9TH ST N PO BOX 108
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City | NORTHWOOD
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State | IA
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Zip | 50459-0108
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Country | US
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Telephone | 641-324-1712
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Fax | 641-324-3091
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SCOTT HALBACH
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Credential |
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Telephone | 641-324-1712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 980326
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 980326
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 980326
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License Number State | IA
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