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Organization
COUNTRYSIDE RETIREMENT HOME OF SIOUX CITY, IOWA
Active
Organization
COUNTRYSIDE RETIREMENT HOME OF SIOUX CITY, IOWA
Active
Other names
Countryside Retirement Home, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE MENZENBERG (EXECUTIVE DIRECTOR)
(712) 276-3000
Entity
Organization
Contact information
Practice address
6120 MORNINGSIDE AVE, SIOUX CITY, IA 51106-3943
(712) 276-3000
(712) 266-2167
Mailing address
6120 MORNINGSIDE AVE, SIOUX CITY, IA 51106-3943
(712) 276-3000
(712) 266-2167
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
R-0370
IA
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N-0370
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800300
—
IA
Enumeration date
07/15/2005
Last updated
09/11/2009
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