Edencrest At Kettlestone, LLC
Assisted Living Facility in Waukee, IA. Organization (NPI-2).
NPI number1215822366
StatusActive
Last updated in NPPESJun 13, 2025
Details
- NPI
- 1215822366
- Entity type
- Organization (NPI-2)
- Legal business name
- Edencrest At Kettlestone, LLC
- Organization subpart
- No
- Enumeration date
- Jun 10, 2025
- Certification date
- Jun 13, 2025
- Last updated
- Jun 13, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Other names
- Edencrest At Kettlestone, LLC (Doing Business As)
Practice location
805 Se Tallgrass LnWaukee, IA 50263-6819
Phone 515-498-5380
Mailing address
6900 Westown PkwyWest Des Moines, IA 50266-2520
Phone 515-243-3228
Authorized official
Susan Cunningham
Director Of Wellness
5155109022
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