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Organization

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Organization subpart
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Provider details

NPI number
Authorized official
MYRANDA THORESON RN (OWNER)
(712) 346-7853
Entity
Organization

Contact information

Practice address
401 1/2 GRAND AVE APT 21, SPENCER, IA 51301-4015
(712) 346-7853
Mailing address
401 1/2 GRAND AVE APT 21, SPENCER, IA 51301-4015
(712) 346-7853

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
131859
IA
251J00000X
Nursing Care Agency
Primary
131859
IA

Other

Enumeration date
08/19/2014
Last updated
08/19/2014
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