Organization
EDGEWOOD CONVALESCENT HOME, INC.
Active
Other names
Edgewood Convalescent Home
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN PERRINJAQUET (AUTHORIZED OFFICIAL)
(563) 928-6461
Entity
Organization
Contact information
Practice address
513 BELL ST, EDGEWOOD, IA 52042-0039
(563) 928-6461
(563) 928-6462
Mailing address
PO BOX 39, EDGEWOOD, IA 52042-0039
(563) 928-6461
(563) 928-6462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
280322
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0801084
—
IA
01
—
16D0671499
CLIA
IA
Enumeration date
03/24/2006
Last updated
02/09/2022
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