Organization
AHF KENTUCKY IOWA, INC
Active
Other names
WILLOW GARDENS CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK T HAEMMERLE CPA, INACTIVE (PRESIDENT)
(614) 760-7352
Entity
Organization
Contact information
Practice address
455 31ST ST, MARION, IA 52302-3723
(319) 377-7363
(319) 377-6022
Mailing address
5920 VENTURE DR STE 100, DUBLIN, OH 43017-2236
(614) 760-7352
(614) 760-7356
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N604
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10808402
—
KY
Enumeration date
12/02/2005
Last updated
03/09/2020
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