# RISEN SON CHRISTIAN VILLAGE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134149529
- **Authorized official:** MRS. SUSAN MCGHEE (CONTROLLER)
- **Authorized official phone:** (217) 732-5175

## Contact information

- **Practice address:** 3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503-1911
- **Practice address phone:** (712) 366-9655
- **Practice address fax:** (712) 366-4748
- **Mailing address:** 3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503-1911
- **Mailing address phone:** (712) 366-9655
- **Mailing address fax:** (712) 366-4748

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 780641 | IA | — |
| 311500000X | Alzheimer Center (Dementia Center) | 780641 | IA | Yes |
| 314000000X | Skilled Nursing Facility | 780641 | IA | — |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0808592 | — | IA |
| 05 | — | 0895557 | — | IA |
| 01 | — | 65466 | WELLMARK BC/BS | IA |