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General NPI Number Information
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NPI Number | 1659330470
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Entity Type | Organization
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Legal Business Name | ANAMOSA NURSING HOME COMPANY LLC
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 1209 E 3RD ST
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City | ANAMOSA
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State | IA
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Zip | 52205-1503
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Country | US
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Telephone | 319-462-4356
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Fax | 319-462-5038
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Provider Business Mailing Address
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Address Line | 1209 E 3RD ST
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City | ANAMOSA
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State | IA
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Zip | 52205-1503
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Country | US
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Telephone | 319-462-4356
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Fax | 319-462-5038
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DONALD L CHENSVOLD
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Credential |
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Telephone | 319-362-8916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 530253
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License Number State | IA
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