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Organization
BUENA VISTA MANOR, INC.
Active
Organization
BUENA VISTA MANOR, INC.
Active
Other names
Buena Vista Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH D. CARLSON (GENERAL MANAGER)
(515) 223-6064
Entity
Organization
Contact information
Practice address
1325 LAKE AVE, STORM LAKE, IA 50588-1907
(515) 223-6064
(515) 226-1244
Mailing address
1325 LAKE AVE, STORM LAKE, IA 50588-1907
(515) 233-6064
(515) 226-1244
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
0478248
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0478248
—
IA
Enumeration date
05/16/2007
Last updated
07/15/2011
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