Organization
HIAWATHA CARE CENTER INC
Active
Other names
Hiawatha Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH D. CARLSON (CORPORATE SECRETARY)
(515) 223-6064
Entity
Organization
Contact information
Practice address
405 N 15TH AVE, HIAWATHA, IA 52233-2347
(319) 378-8583
(319) 378-8598
Mailing address
405 N 15TH AVE, HIAWATHA, IA 52233-2347
(319) 378-8583
(319) 378-8598
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
570660
IA
314000000X
Skilled Nursing Facility
570660
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809236
—
IA
Enumeration date
06/22/2005
Last updated
01/27/2012
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