Organization
EDGEWOOD CONVALESCENT HOME INC
Active
Other names
Lincolnwood Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L CHENSVOLD (MANAGER)
(319) 362-8916
Entity
Organization
Contact information
Practice address
302 W LINCOLN, EDGEWOOD, IA 52042-0039
(563) 928-7173
(563) 928-6462
Mailing address
PO BOX 39, EDGEWOOD, IA 52042-0039
(563) 928-7173
(563) 928-6462
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0082
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212076
—
IA
Enumeration date
04/23/2007
Last updated
08/22/2020
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