MEDICARE: PLEASANT MANOR CARE CENTER

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	313M00000X	Nursing Facility/Intermediate Care Facility	N0237	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1982698296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT MANOR CARE CENTER

Provider Business Mailing Address
First Line	:	413 N BROADWAY ST
Second Line	:
City	:	MT PLEASANT
State	:	IA
Zip	:	52641-1609
Country	:	US
Telephone Number	:	319-385-8095
Fax Number	:	319-385-3372

Provider Business Practice Location Address
First Line	:	413 N BROADWAY ST
Second Line	:
City	:	MT PLEASANT
State	:	IA
Zip	:	52641-1609
Country	:	US
Telephone Number	:	319-385-8095
Fax Number	:	319-385-3372

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MICHAEL WILLIAM HOCKING
Credential	:
Telephone Number	:	319-385-8095

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	08/22/2020

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Directions to “PLEASANT MANOR CARE CENTER ” Practice Location

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