Organization
FIVE STAR QUALITY CARE-IA, LLC
Active
Parent organization
FIVE STAR QUALITY CARE-IA, LLC
Other names
Pacific Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE-IA, LLC
Authorized official
BRUCE J MACKEY JR. (CEO)
(617) 796-8387
Entity
Organization
Contact information
Practice address
20937 KANE AVE, PACIFIC JUNCTION, IA 51561-4242
(712) 622-8144
(712) 622-8158
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
(617) 796-8387
(617) 796-8375
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0881573
—
IA
Enumeration date
05/26/2006
Last updated
05/29/2008
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