Organization
ELMWOOD CARE CENTER LLC
Active
Other names
Elmwood Care Centre
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY S BENCH (AUTHORIZED REPRESENTATIVE)
(941) 758-4745
Entity
Organization
Contact information
Practice address
222 15TH ST, ONAWA, IA 51040-1025
(712) 423-2510
(712) 423-1754
Mailing address
11523 PALMBRUSH TRL, SUITE 331, LAKEWOOD RANCH, FL 34202-2917
(941) 758-4745
(888) 391-2373
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
314000000X
Skilled Nursing Facility
Primary
670321
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166074
—
IA
05
—
0223552
—
IA
05
—
0800079
—
IA
05
—
0807487
—
IA
Enumeration date
04/07/2006
Last updated
05/10/2012
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