Organization
KISMET SPL - A, LLC
Active
Other names
WEL-Life at Spirit Lake
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization
Contact information
Practice address
1819 23RD ST, SPIRIT LAKE, IA 51360-7096
(712) 336-3553
(712) 336-5717
Mailing address
1819 23RD ST, SPIRIT LAKE, IA 51360-7096
(712) 336-3553
(712) 336-5717
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0025
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0404033
—
IA
Enumeration date
02/03/2016
Last updated
02/27/2019
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