Organization
PRAIRIE VIEW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY NELSON (ADMINISTRATOR)
(712) 930-3228
Entity
Organization
Contact information
Practice address
610 N EASTERN ST, SANBORN, IA 51248-1089
(712) 930-3228
(712) 930-3138
Mailing address
610 N EASTERN ST, SANBORN, IA 51248-1089
(712) 930-3228
(712) 930-3138
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
N-410
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0803320
—
IA
Enumeration date
09/02/2005
Last updated
08/22/2020
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