Organization
SHIRLEES RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY UDENE BAKER (ADMINISTRATOR)
(515) 961-6673
Entity
Organization
Contact information
Practice address
1302 E 2ND AVE, INDIANOLA, IA 50125-2804
(515) 961-6673
(515) 961-2737
Mailing address
1302 E 2ND AVE, INDIANOLA, IA 50125-2804
(515) 961-6673
(515) 961-2737
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
251J00000X
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0891481
—
IA
Enumeration date
04/30/2008
Last updated
04/30/2008
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