Organization
ABCM CORPORATION
Active
Other names
Leahy Grove Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ROBERTS (CFO)
(641) 456-5636
Entity
Organization
Contact information
Practice address
800 2ND ST SE, HAMPTON, IA 50441-2626
(641) 456-2701
Mailing address
1320 4TH ST NE, HAMPTON, IA 50441-1104
(641) 456-5636
(641) 456-2320
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NOT ASSIGNED
MEDICAID WAIVER
IA
Enumeration date
11/18/2009
Last updated
11/18/2009
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