Organization
MALLARD VIEW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY PETER (ADMINISTRATOR)
(712) 792-3785
Entity
Organization
Contact information
Practice address
17504 MAHOGANY AVE, CARROLL, IA 51401-8870
(712) 792-3785
Mailing address
17504 MAHOGANY AVE, CARROLL, IA 51401-8870
(712) 792-3785
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
001
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0895243
—
IA
Enumeration date
01/04/2007
Last updated
07/21/2022
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