Organization
LUTHERAN RETIREMENT HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT HALBACH (ADMINISTRATOR)
(641) 324-1712
Entity
Organization
Contact information
Practice address
701 9TH ST N, NORTHWOOD, IA 50459-1004
(641) 324-1712
(641) 324-3091
Mailing address
701 9TH ST N, PO BOX 108, NORTHWOOD, IA 50459-0108
(641) 324-1712
(641) 324-3091
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
980326
IA
313M00000X
Nursing Facility/Intermediate Care Facility
980326
IA
314000000X
Skilled Nursing Facility
Primary
980326
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03173110
AMERIGROUP
IA
05
—
0802355
—
IA
01
—
65485
BCBS OF IOWA
IA
Enumeration date
08/31/2005
Last updated
09/16/2020
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