# LONGHOUSE-NORTHSHIRE, LTD

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

## Provider details

- **NPI number:** 1326254004
- **Authorized official:** MR. DAVE W SOUCEK (ASST ADM)
- **Authorized official phone:** (712) 262-2344

## Contact information

- **Practice address:** 711 W 11TH ST, SPENCER, IA 51301-3237
- **Practice address phone:** (712) 262-2344
- **Practice address fax:** (712) 262-3550
- **Mailing address:** 711 W 11TH ST, SPENCER, IA 51301-3237
- **Mailing address phone:** (712) 262-2344
- **Mailing address fax:** (712) 262-3550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 210065 | IA | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0450965 | — | IA |