Organization
OPCO SIOUX CITY, IA, LLC
Active
Other names
Countryside Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC DOLE (PRESIDENT/CEO)
(773) 645-9246
Entity
Organization
Contact information
Practice address
6120 MORNINGSIDE AVE, SIOUX CITY, IA 51106-3943
(712) 276-3000
Mailing address
6120 MORNINGSIDE AVE, SIOUX CITY, IA 51106-3943
(712) 276-3000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
10/29/2024
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