Organization
HAWKEYE CARE CENTER OF SPIRIT LAKE, LLC
Active
Other names
Hawkeye Care Center Spirit Lake
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG JOHNSON (PRESIDENT)
(515) 223-0173
Entity
Organization
Contact information
Practice address
1912 ZENITH AVE, SPIRIT LAKE, IA 51360
(712) 336-3300
Mailing address
1912 ZENITH AVE, SUITE 2526, SPIRIT LAKE, IA 51360-1000
(712) 759-1321
(712) 759-1322
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
300353
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809475
—
IA
Enumeration date
02/03/2006
Last updated
09/01/2015
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