Organization
CREST HAVEN CARE CENTER, LLC
Active
Other names
Crest Haven Care Centre
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY S BENCH (AUTHORIZED REPRESENTATIVE)
(941) 758-4745
Entity
Organization
Contact information
Practice address
1000 E HOWARD ST, CRESTON, IA 50801-2723
(641) 782-5012
(641) 782-5309
Mailing address
11523 PALMBRUSH TRL, SUITE 331, LAKEWOOD RANCH, FL 34202-2917
(941) 758-4745
(888) 391-2373
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
880066
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236984
—
IA
05
—
0800080
—
IA
05
—
0800425
—
IA
Enumeration date
04/06/2006
Last updated
06/27/2012
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