# METHODIST MANOR RETIREMENT COMMUNITY

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

## Provider details

- **NPI number:** 1184709115
- **Authorized official:** NICHOLAS LANDGRAF (DIRECTOR OF FINANCE)
- **Authorized official phone:** (712) 732-1120

## Contact information

- **Practice address:** 1206 W 4TH ST, STORM LAKE, IA 50588-3002
- **Practice address phone:** (712) 732-1120
- **Practice address fax:** (712) 732-3406
- **Mailing address:** 1206 W 4TH ST, STORM LAKE, IA 50588-3002
- **Mailing address phone:** (712) 732-1120
- **Mailing address fax:** (712) 732-3406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 110001 | IA | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 04/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0802686 | — | IA |