MEDICARE: ABILIT HOLDINGS (CEDAR POINTE) 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	:	1538714340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILIT HOLDINGS (CEDAR POINTE) LLC

Provider Business Mailing Address
First Line	:	6132 NE 12TH AVE
Second Line	:
City	:	PLEASANT HILL
State	:	IA
Zip	:	50327-8911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6132 NE 12TH AVE
Second Line	:
City	:	PLEASANT HILL
State	:	IA
Zip	:	50327-8911
Country	:	US
Telephone Number	:	515-957-8399
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TINA OVERTON
Credential	:
Telephone Number	:	515-957-8399

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	08/08/2019

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