Organization
FIVE STAR QUALITY CARE IA LLC
Active
Parent organization
FIVE STAR QUALITY CARE IA LLC
Other names
Prairie Ridge Care & Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE IA LLC
Authorized official
KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 796-8387
Entity
Organization
Contact information
Practice address
608 PRAIRIE ST, MEDIAPOLIS, IA 52637-7843
(319) 394-3991
(319) 394-3041
Mailing address
608 PRAIRIE ST, MEDIAPOLIS, IA 52637-7843
(319) 394-3991
(319) 394-3041
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
290810
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805382
—
IA
Enumeration date
05/24/2006
Last updated
03/28/2019
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