Organization
EHLERS LANE LC
Active
Other names
Clover Ridge Place
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNNE POPP SW (MANAGER)
(563) 652-2125
Entity
Organization
Contact information
Practice address
205 EHLERS LN, MAQUOKETA, IA 52060-9615
(563) 652-2125
(563) 652-0145
Mailing address
205 EHLERS LN, MAQUOKETA, IA 52060-9615
(563) 652-2125
(563) 652-0145
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0078
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0275073
—
IA
Enumeration date
05/08/2007
Last updated
06/11/2008
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