# CCRC OF CEDAR RAPIDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Terrace Glen Village
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972041952
- **Authorized official:** GILBERT R WOOD (MANAGER OF THE LLC)
- **Authorized official phone:** (913) 599-5705

## Contact information

- **Practice address:** 11827 W 112TH ST, SUITE 103, OVERLAND PARK, KS 66210
- **Practice address phone:** (913) 890-4780
- **Mailing address:** 3400 ALBURNETT ROAD, MARION, IA 52302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | IA | Yes |

## Other

- **Enumeration date:** 02/09/2017
- **Last updated:** 08/02/2018