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Organization
PROFFITT'S RESIDENTIAL
Active
Organization
PROFFITT'S RESIDENTIAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CATHERINE PROFFITT (OWNER)
(641) 856-8344
Entity
Organization
Contact information
Practice address
615 WEST WASHINGTON ST, CENTERVILLE, IA 52544-1623
(641) 856-8344
(641) 437-4161
Mailing address
615 W WASHINGTON ST, CENTERVILLE, IA 52544-1623
(641) 856-8344
(641) 437-4161
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
R542
IA
Other
Enumeration date
03/09/2007
Last updated
08/22/2020
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