Organization
ABCM CORPORATION
Active
Other names
Cherry Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ROBERTS (CFO)
(641) 456-5636
Entity
Organization
Contact information
Practice address
217 HIGHWAY 30 SW, MOUNT VERNON, IA 52314-1597
(319) 895-8249
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
S0124
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0725978
MEDICAID AL WAIVER
IA
Enumeration date
08/15/2005
Last updated
10/12/2009
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