Organization
FAITH LUTHERAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LADONNA M GUNDERSON (ADMINISTRATOR)
(641) 732-5511
Entity
Organization
Contact information
Practice address
914 DAVIDSON DR, OSAGE, IA 50461-1475
(641) 732-5941
Mailing address
914 DAVIDSON DR, OSAGE, IA 50461-1475
(641) 732-5941
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N-081
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0801233
—
IA
01
—
65433
BLUE CROSS OF IOWA
IA
Enumeration date
06/09/2005
Last updated
08/22/2020
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