Organization
CARDINAL CARE CORP
Active
Other names
Danville Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC R JOHNSON (PRESIDENT)
(217) 440-9588
Entity
Organization
Contact information
Practice address
401 S BIRCH ST, DANVILLE, IA 52623-9613
(319) 392-4259
(319) 392-4078
Mailing address
31 S 31ST ST STE 2, KEOKUK, IA 52632-2264
(319) 524-2029
(319) 524-2046
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
290870
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805606
—
IA
01
—
16D0691717
CLIA
IA
Enumeration date
03/21/2006
Last updated
01/08/2015
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