Organization
MADRID HOME FOR THE AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIS HANSEN (PRESIDENT/CEO)
(515) 795-3007
Entity
Organization
Contact information
Practice address
613 W NORTH ST, MADRID, IA 50156-1023
(515) 795-3007
(515) 795-2138
Mailing address
613 W NORTH ST, MADRID, IA 50156-1023
(515) 795-3007
(515) 795-2138
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
080797
IA
314000000X
Skilled Nursing Facility
080797
IA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0258863
—
IA
05
—
0802371
—
IA
Enumeration date
03/27/2006
Last updated
07/16/2019
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