Premier Estates 506, LLC
Skilled Nursing Facility in Iowa City, IA. Organization (NPI-2).
NPI number1083070783
StatusActive
Last updated in NPPESJan 9, 2018
Details
- NPI
- 1083070783
- Entity type
- Organization (NPI-2)
- Legal business name
- Premier Estates 506, LLC
- Organization subpart
- No
- Enumeration date
- Jan 11, 2016
- Last updated
- Jan 9, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 520052 | IA | Yes |
Practice location
3661 Rochester AveIowa City, IA 52245-9271
Phone 319-351-7460 · Fax 319-354-8428
Mailing address
5115 E State Road 64Bradenton, FL 34208-5509
Phone 941-758-4745 · Fax 941-751-2135
Authorized official
Cassidy Bancroft
Controller
9417584745
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