Organization
THE PRIDE GROUP
Active
Other names
Plymouth Life, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JILLIAN MARIE BRITT (HR)
(712) 546-6500
Entity
Organization
Contact information
Practice address
214 PLYMOUTH ST SE, LE MARS, IA 51031-3631
(712) 546-6500
(712) 546-6589
Mailing address
214 PLYMOUTH ST SE, LE MARS, IA 51031-3631
(712) 546-6500
(712) 546-6589
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
180932
IA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
710257
IA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
750562
IA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
RMR-40
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0893735
—
IA
05
—
0894485
—
IA
05
—
0896498
—
IA
05
—
0896639
—
IA
Enumeration date
06/27/2007
Last updated
02/12/2015
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