Organization
CHRISTIAN RETIREMENT HOMES, INC.
Active
Other names
Ridgecrest Village
Organization subpart
No
Provider details
NPI number
Authorized official
BERT VIGEN (EXECUTIVE DIRECTOR)
(563) 391-3430
Entity
Organization
Contact information
Practice address
4130 NORTHWEST BLVD, DAVENPORT, IA 52806-4243
(563) 391-3430
(563) 388-3287
Mailing address
4130 NORTHWEST BLVD, DAVENPORT, IA 52806-4243
(563) 391-3430
(563) 388-3287
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
S0139
IA
311500000X
Alzheimer Center (Dementia Center)
S0139
IA
313M00000X
Nursing Facility/Intermediate Care Facility
N0407
IA
314000000X
Skilled Nursing Facility
Primary
N0407
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803403
—
IA
Enumeration date
08/22/2005
Last updated
01/03/2012
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