Organization
SIGNATURE PROPERTIES OF LAKE PARK, LLC
Active
Other names
Lake Park Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE H. MEHLHOP MA (MANAGING MEMBER)
(515) 727-1770
Entity
Organization
Contact information
Practice address
1304 SOUTH MARKET, LAKE PARK, IA 51347-1060
(712) 832-3691
(712) 832-9548
Mailing address
1304 SOUTH MARKET, LAKE PARK, IA 51347-1060
(712) 832-3691
(712) 832-9548
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
300598
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809731
—
IA
Enumeration date
11/15/2005
Last updated
01/20/2012
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