Organization
SUNNYBROOK ASSISTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY DIANE HOWELL (VICE PRESIDENT)
(641) 469-5778
Entity
Organization
Contact information
Practice address
3000 W MADISON AVE, FAIRFIELD, IA 52556-4205
(641) 469-5778
(641) 469-4529
Mailing address
3000 W MADISON AVE, FAIRFIELD, IA 52556-4205
(641) 469-5778
(641) 469-4529
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
SO170
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0158717
—
IA
Enumeration date
05/03/2007
Last updated
08/22/2020
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