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Organization

MADISON SQUARE ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STANLEY BIRCHEM (PRESIDENT/OWNER)
(515) 462-5087
Entity
Organization

Contact information

Practice address
209 W JEFFERSON ST, WINTERSET, IA 50273-1676
(515) 462-5087
(515) 462-9058
Mailing address
209 W JEFFERSON ST, WINTERSET, IA 50273-1676
(515) 462-5087
(515) 462-9058

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
S0080
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0426007
IA
Enumeration date
01/07/2008
Last updated
01/07/2008
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