Organization
PREMIER ESTATES 505, LLC
Active
Other names
Pleasant Acres Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE CULP (CONTROLLER)
(941) 758-4745
Entity
Organization
Contact information
Practice address
309 RAILROAD ST, HULL, IA 51239-7413
(712) 439-2758
(712) 439-2764
Mailing address
5115 E STATE ROAD 64, BRADENTON, FL 34208-5509
(941) 758-4745
(941) 751-2135
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
840120
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0800182
—
IA
Enumeration date
01/11/2016
Last updated
06/10/2016
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