Organization
EASTERN STAR MASONIC HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT DYLAN ARMSTRONG (DIRECTOR OF COMPLIANCE)
(515) 709-4398
Entity
Organization
Contact information
Practice address
715 W MAMIE EISENHOWER AVE, BOONE, IA 50036-3930
(515) 432-5274
(515) 432-5276
Mailing address
715 W MAMIE EISENHOWER AVE, BOONE, IA 50036-3930
(515) 432-5274
(515) 432-5276
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
R-268
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0890210
—
IA
05
—
X000298224
—
IA
Enumeration date
11/07/2006
Last updated
01/27/2025
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