Organization
METHODIST MANOR RETIREMENT COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS LANDGRAF (DIRECTOR OF FINANCE)
(712) 732-1120
Entity
Organization
Contact information
Practice address
1206 W 4TH ST, STORM LAKE, IA 50588-3002
(712) 732-1120
(712) 732-3406
Mailing address
1206 W 4TH ST, STORM LAKE, IA 50588-3002
(712) 732-1120
(712) 732-3406
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
110001
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802686
—
IA
Enumeration date
10/26/2006
Last updated
04/19/2012
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