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Organization

COTTAGE GROVE PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM C. JACOBSON (BOARD CHAIR)
(319) 363-2420
Entity
Organization

Contact information

Practice address
2115 1ST AVE SE, CEDAR RAPIDS, IA 52402
(319) 363-2420
(319) 297-5646
Mailing address
2115 1ST AVE SE, CEDAR RAPIDS, IA 52402-6353
(319) 363-2420
(319) 297-5646

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
570783
IA

Other

Enumeration date
01/10/2006
Last updated
08/28/2019
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