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General NPI Number Information
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NPI Number | 1538243266
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Entity Type | Organization
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Legal Business Name | WESTHAVEN COMMUNITY A MINISTRY OF THE EVANGELICAL FREE CHURCH
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 112 W 4TH ST
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City | BOONE
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State | IA
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Zip | 50036-3305
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Country | US
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Telephone | 515-432-1393
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Fax | 515-432-7882
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Provider Business Mailing Address
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Address Line | 112 W 4TH ST
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City | BOONE
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State | IA
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Zip | 50036-3305
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Country | US
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Telephone | 515-432-1393
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Fax | 515-432-7882
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NANCY R SLOAN
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Credential | N.H.A
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Telephone | 515-432-1393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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