Organization
PLYMOUTH MANOR INC
Active
Other names
Plymouth Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RICHARD AMLIE (PRESIDENT)
(319) 290-1490
Entity
Organization
Contact information
Practice address
954 7TH AVE SE, LE MARS, IA 51031-2602
(712) 546-7831
(712) 546-7990
Mailing address
954 7TH AVE SE, LE MARS, IA 51031-2602
(712) 546-7831
(712) 546-7990
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
750234
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803288
—
IA
Enumeration date
01/09/2006
Last updated
03/27/2012
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