Organization
COUNTY OF BLACKHAWK
Active
Other names
Country View
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS C. MEYER (PROVISIONAL ADMINISTRATOR)
(319) 291-2509
Entity
Organization
Contact information
Practice address
1410 W DUNKERTON RD, WATERLOO, IA 50703-9648
(319) 291-2509
(319) 291-2570
Mailing address
1410 W DUNKERTON RD, WATERLOO, IA 50703-9648
(319) 291-2509
(319) 291-2570
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
070529
IA
314000000X
Skilled Nursing Facility
Primary
070529
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181776
—
IA
05
—
0806984
—
IA
Enumeration date
06/16/2005
Last updated
05/10/2013
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