# HIAWATHA CARE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hiawatha Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285630541
- **Authorized official:** KENNETH D. CARLSON (CORPORATE SECRETARY)
- **Authorized official phone:** (515) 223-6064

## Contact information

- **Practice address:** 405 N 15TH AVE, HIAWATHA, IA 52233-2347
- **Practice address phone:** (319) 378-8583
- **Practice address fax:** (319) 378-8598
- **Mailing address:** 405 N 15TH AVE, HIAWATHA, IA 52233-2347
- **Mailing address phone:** (319) 378-8583
- **Mailing address fax:** (319) 378-8598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 570660 | IA | Yes |
| 314000000X | Skilled Nursing Facility | 570660 | IA | — |

## Other

- **Enumeration date:** 06/22/2005
- **Last updated:** 01/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0809236 | — | IA |