Organization
FIVE STAR QUALITY CARE IA LLC
Active
Parent organization
FIVE STAR QUALITY CARE IA LLC
Other names
Northcrest Care & Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE IA LLC
Authorized official
BRUCE J MACKEY JR. (CEO)
(617) 796-8387
Entity
Organization
Contact information
Practice address
34 NORTHCREST DR, COUNCIL BLUFFS, IA 51503-1622
(712) 328-2333
(712) 328-2960
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
(617) 796-8387
(617) 796-8375
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
780853
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805390
—
IA
Enumeration date
05/24/2006
Last updated
05/29/2008
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