Organization
PLYMOUTH LIFE, INC.
Active
Other names
Pride Group, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN MARIE BRITT (HR MANAGER)
(712) 546-6500
Entity
Organization
Contact information
Practice address
214 PLYMOUTH ST SE, LE MARS, IA 51031-3631
(712) 546-6500
(712) 546-6589
Mailing address
214 PLYMOUTH ST SE, LE MARS, IA 51031-3631
(712) 546-6500
(712) 546-6589
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108423
—
IA
05
—
0232041
—
IA
05
—
0242990
—
IA
05
—
0245100
—
IA
05
—
0251561
—
IA
05
—
0741983
—
IA
05
—
0764415
—
IA
05
—
0769471
—
IA
Enumeration date
01/08/2007
Last updated
01/28/2015
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