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Organization
THOMAS REST HAVEN
Active
Organization
THOMAS REST HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE VENTEICHER (ADMINISTRATOR)
(712) 999-2253
Entity
Organization
Contact information
Practice address
217 MAIN ST, COON RAPIDS, IA 50058-1605
(712) 999-2253
(712) 999-5669
Mailing address
217 MAIN ST, COON RAPIDS, IA 50058-1605
(712) 999-2253
(712) 999-5669
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
140430
IA
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
140430
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803973
—
IA
01
—
65358
WELLMARK
IA
Enumeration date
11/17/2005
Last updated
12/14/2011
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