Organization
EVANS MEMORIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L CHENSVOLD (MANAGER)
(319) 362-8916
Entity
Organization
Contact information
Practice address
1010 N ELM ST, CRESCO, IA 52136-1083
(563) 547-2364
(563) 547-5013
Mailing address
1010 N ELM ST, CRESCO, IA 52136-1083
(563) 547-2364
(563) 547-5013
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
450329
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0461509
—
IA
Enumeration date
04/19/2007
Last updated
08/22/2020
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