MEDICARE: ST ANTHONY SENIOR SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1053240085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST ANTHONY SENIOR SERVICES LLC

Provider Business Mailing Address
First Line	:	311 S CLARK ST
Second Line	:
City	:	CARROLL
State	:	IA
Zip	:	51401-3038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 S MAPLE ST
Second Line	:
City	:	CARROLL
State	:	IA
Zip	:	51401-3113
Country	:	US
Telephone Number	:	712-794-5050
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	ALLEN ANDERSON
Credential	:
Telephone Number	:	712-792-3581

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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