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NPI Code Detail

MEDICARE: LUTHERAN HOME FOR THE AGED ASSOCIATION-EAST

MEDICARE: LUTHERAN HOME FOR THE AGED ASSOCIATION-EAST
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
1314000000XSkilled Nursing Facility820211IA

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 : 1730259813
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN HOME FOR THE AGED ASSOCIATION-EAST
Provider Business Mailing Address
First Line : PO BOX 559
Second Line :
City : VINTON
State : IA
Zip : 52349-0559
Country : US
Telephone Number : 319-472-4211
Fax Number : 319-472-2256
Provider Business Practice Location Address
First Line : 1130 W 53RD ST
Second Line :
City : DAVENPORT
State : IA
Zip : 52806-2401
Country : US
Telephone Number : 563-391-5342
Fax Number : 319-472-2256
Authorized Official
Title or Position : COO
Name : DIANE GLOEDE
Credential :
Telephone Number : 319-472-4211
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/13/2016

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Directions to “LUTHERAN HOME FOR THE AGED ASSOCIATION-EAST ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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