Organization
BETHANY LUTHERAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL VAN SICKLE (ADMINISTRATOR)
(712) 328-9500
Entity
Organization
Contact information
Practice address
7 ELLIOTT ST, COUNCIL BLUFFS, IA 51503-0239
(712) 328-9500
(712) 309-0190
Mailing address
7 ELLIOTT ST, COUNCIL BLUFFS, IA 51503-0239
(712) 328-9500
(712) 309-0190
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800227
—
IA
Enumeration date
11/04/2005
Last updated
08/22/2020
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