Organization
GRAND HAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JONI FAHRENKROG (MANAGER)
(563) 285-4900
Entity
Organization
Contact information
Practice address
201 EAST FRANKLIN ST, ELDRIDGE, IA 52748
(563) 285-4900
(563) 285-4911
Mailing address
201 E. FRANKLIN ST, ELDRIDGE, IA 52748
(563) 285-4900
(563) 285-4911
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0260
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S0260
ASSISTED LIVING
IA
Enumeration date
08/20/2007
Last updated
08/20/2007
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