Organization
METH WICK COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN SCHMITT (ADMINISTRATOR)
(319) 365-9171
Entity
Organization
Contact information
Practice address
1224 13TH ST NW, CEDAR RAPIDS, IA 52405-2404
(319) 365-9171
(319) 364-5033
Mailing address
1224 13TH ST NW, CEDAR RAPIDS, IA 52405-2404
(319) 365-9171
(319) 364-5033
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
165542
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0802678
—
IA
01
—
65542
BLUE CROSS BLUE SHEILD
IA
Enumeration date
09/15/2005
Last updated
01/30/2008
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