Organization
HOMESTEAD OF OSKALOOSA OPERATIONS LLC
Active
Other names
Maple Ridge Assistant Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE TRYON (CHIEF FINANCIAL OFFICER)
(785) 228-7913
Entity
Organization
Contact information
Practice address
2102 SOUTH MARKET STREET, OSKALOOSA, IA 52577
(641) 672-1090
(641) 672-1116
Mailing address
3715 SW 29TH STREET, TOPEKA, KS 66614
(785) 272-1535
(785) 272-1480
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
S0186
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0428839
—
IA
Enumeration date
04/16/2007
Last updated
11/10/2011
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