Organization
IOWA JEWISH SENIOR LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENE E. WIESE (ACCOUNTING MANAGER)
(515) 255-5433
Entity
Organization
Contact information
Practice address
900 POLK BLVD, DES MOINES, IA 50312-2225
(515) 255-5433
(515) 277-8898
Mailing address
900 POLK BLVD, DES MOINES, IA 50312-2225
(515) 255-5433
(515) 277-8898
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N-384
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802025
—
IA
Enumeration date
10/29/2008
Last updated
10/29/2008
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