Organization
UNITED PRESBYTERIAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D MOORE (CEO/ADMINISTRATOR)
(319) 653-5473
Entity
Organization
Contact information
Practice address
1203 E WASHINGTON ST, WASHINGTON, IA 52353-2168
(319) 653-5473
(319) 653-5474
Mailing address
1203 E WASHINGTON ST, WASHINGTON, IA 52353-2168
(319) 653-5473
(319) 653-5474
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N303
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408054
—
IA
Enumeration date
08/29/2005
Last updated
08/22/2020
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