Organization
BOARD OF TRUSTEES GRAND CHARITY FUND GRAND LODGE OF IOWA A F & A M
Active
Other names
Iowa Masonic Health Facilities
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI TEGELER (EXECUTIVE DIRECTOR)
(815) 499-7751
Entity
Organization
Contact information
Practice address
2500 GRANT ST, BETTENDORF, IA 52722-5092
(563) 359-9171
(563) 359-6900
Mailing address
2500 GRANT ST, BETTENDORF, IA 52722-5092
(563) 359-9171
(563) 359-6900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
820296
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802033
—
IA
01
—
65553
BCBS PROVIDER #
IA
Enumeration date
11/27/2006
Last updated
04/19/2024
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