# PROFFITT'S RESIDENTIAL

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

## Provider details

- **NPI number:** 1750412672
- **Authorized official:** MARY CATHERINE PROFFITT (OWNER)
- **Authorized official phone:** (641) 856-8344

## Contact information

- **Practice address:** 615 WEST WASHINGTON ST, CENTERVILLE, IA 52544-1623
- **Practice address phone:** (641) 856-8344
- **Practice address fax:** (641) 437-4161
- **Mailing address:** 615 W WASHINGTON ST, CENTERVILLE, IA 52544-1623
- **Mailing address phone:** (641) 856-8344
- **Mailing address fax:** (641) 437-4161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | R542 | IA | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 08/22/2020