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NPI Code Detail

MEDICARE: SPURGEON MANOR, INC.

MEDICARE: SPURGEON MANOR, INC.
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
1313M00000XNursing Facility/Intermediate Care FacilityN-199IA
2314000000XSkilled Nursing FacilityN-199IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083738132
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPURGEON MANOR, INC.
Provider Business Mailing Address
First Line : 1204 LINDEN ST
Second Line :
City : DALLAS CENTER
State : IA
Zip : 50063-1052
Country : US
Telephone Number : 515-992-3735
Fax Number : 515-992-3098
Provider Business Practice Location Address
First Line : 1204 LINDEN ST
Second Line :
City : DALLAS CENTER
State : IA
Zip : 50063-1052
Country : US
Telephone Number : 515-992-3735
Fax Number : 515-992-3098
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MAUREEN MARIE CAHILL
Credential :
Telephone Number : 515-992-3735
Provider Enumeration Date : 03/16/2007
Last Update Date : 05/01/2009

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Directions to “SPURGEON MANOR, INC. ” Practice Location

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