Organization
MIDLANDS LIVING CENTER, L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. ANDERSON (ADMINISTRATOR)
(712) 323-7135
Entity
Organization
Contact information
Practice address
2452 N BROADWAY, COUNCIL BLUFFS, IA 51503-0434
(712) 323-7135
(712) 325-0289
Mailing address
2452 N BROADWAY, COUNCIL BLUFFS, IA 51503-0432
(712) 323-7135
(712) 325-0289
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
780508
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809582
—
IA
Enumeration date
08/15/2005
Last updated
10/26/2011
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