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Organization
HIAWATHA CARE CENTER INC
Active
Organization
HIAWATHA CARE CENTER INC
Active
Other names
Hiawatha Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH D. CARLSON (CORPORATE SECRETARY)
(515) 223-6064
Entity
Organization
Contact information
Practice address
405 N 15TH AVE, HIAWATHA, IA 52233-2347
(319) 378-8583
(319) 378-8598
Mailing address
405 N 15TH AVE, HIAWATHA, IA 52233-2347
(319) 378-8583
(319) 378-8598
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
570660
IA
314000000X
Skilled Nursing Facility
570660
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809236
—
IA
Enumeration date
06/22/2005
Last updated
01/27/2012
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