Organization
GLEN HAVEN HOME, INC.
Active
Other names
Glen Haven Village
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANNE M MARRIOTT NHA (ADMINISTRATOR)
(712) 302-9016
Entity
Organization
Contact information
Practice address
133 INDIAN HILLS DR, GLENWOOD, IA 51534-1911
(712) 302-9016
(712) 302-9017
Mailing address
133 INDIAN HILLS DR, GLENWOOD, IA 51534-1911
(712) 302-9016
(712) 302-9017
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
650355
IA
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0801365
—
IA
01
—
65530
BC BS
IA
Enumeration date
10/26/2006
Last updated
02/26/2026
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