# THOMAS REST HAVEN

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

## Provider details

- **NPI number:** 1215919949
- **Authorized official:** MARY JANE VENTEICHER (ADMINISTRATOR)
- **Authorized official phone:** (712) 999-2253

## Contact information

- **Practice address:** 217 MAIN ST, COON RAPIDS, IA 50058-1605
- **Practice address phone:** (712) 999-2253
- **Practice address fax:** (712) 999-5669
- **Mailing address:** 217 MAIN ST, COON RAPIDS, IA 50058-1605
- **Mailing address phone:** (712) 999-2253
- **Mailing address fax:** (712) 999-5669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 140430 | IA | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 140430 | IA | Yes |

## Other

- **Enumeration date:** 11/17/2005
- **Last updated:** 12/14/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0803973 | — | IA |
| 01 | — | 65358 | WELLMARK | IA |