Organization
BETHANY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLINDA LEE MANTERNACH (ADMINISTRATOR)
(563) 556-5233
Entity
Organization
Contact information
Practice address
1005 LINCOLN AVE, DUBUQUE, IA 52001-3499
(563) 556-5233
(563) 556-3078
Mailing address
1005 LINCOLN AVE, DUBUQUE, IA 52001-3499
(563) 556-5233
(563) 556-3078
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N-307
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800219
—
IA
Enumeration date
10/03/2006
Last updated
10/09/2008
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