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General NPI Number Information
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NPI Number | 1700239712
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Entity Type | Organization
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Legal Business Name | COZY CORNER ADULT DAY CARE
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/14/2016
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Provider Practice Location Address
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Address Line | 2785 PENNSYLVANIA AVE
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City | DUBUQUE
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State | IA
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Zip | 52001-5460
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Country | US
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Telephone | 563-690-6900
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Fax | 563-552-7178
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Provider Business Mailing Address
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Address Line | 2785 PENNSYLVANIA AVE
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City | DUBUQUE
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State | IA
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Zip | 52001-5460
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Country | US
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Telephone | 563-690-6900
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Fax | 563-552-7178
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIKO WILBRICHT
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Credential |
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Telephone | 563-690-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADS109
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License Number State | IA
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