Organization
KISMET ALT-A, LLC
Active
Other names
WEL-Life at Alta
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOORE (CHIEF FINANCIAL OFFICER)
(605) 642-7736
Entity
Organization
Contact information
Practice address
705 W 7TH ST, ALTA, IA 51002-1525
(712) 200-2620
(712) 200-1174
Mailing address
705 W 7TH ST, ALTA, IA 51002-1525
(712) 200-2620
(712) 200-1174
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0096
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047972E
—
IA
Enumeration date
02/03/2016
Last updated
07/15/2021
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