Organization
OPCO 19TH ST. SIOUX CITY, IA, LLC
Active
Other names
Casa De Paz Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (MANAGER OF THE LLC)
(773) 645-9246
Entity
Organization
Contact information
Practice address
2121 W 19TH ST, SIOUX CITY, IA 51103-2333
(712) 233-3127
Mailing address
2045 W GRAND AVE STE B-34572, CHICAGO, IL 60612-1576
(415) 302-5603
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/29/2024
Last updated
10/29/2024
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