Organization
GOOD SHEPHERD GERIATRIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE DEMARIS (BKPR)
(641) 424-1740
Entity
Organization
Contact information
Practice address
302 2ND ST NE, MASON CITY, IA 50401-3412
(641) 424-1740
Mailing address
302 2ND ST NE, MASON CITY, IA 50401-3412
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6106872
—
IA
Enumeration date
11/20/2006
Last updated
08/22/2020
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