Organization
GREENLEAF SENIOR CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY FOWLER (ADMINISTRATOR)
(515) 955-4145
Entity
Organization
Contact information
Practice address
1305 N 22ND ST, FORT DODGE, IA 50501-2117
(515) 955-4145
(515) 955-1731
Mailing address
1305 N 22ND ST, FORT DODGE, IA 50501-2117
(515) 955-4145
(515) 955-1731
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
940016
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809335
—
IA
05
—
0896365
—
IA
Enumeration date
11/09/2006
Last updated
10/30/2007
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