Centers for Long Term Care of Iowa
Organization Active NPI Skilled Nursing Facility · Jefferson, IA
NPI 1477513059 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1477513059
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CENTERS FOR LONG TERM CARE OF IOWA
- Practice address
- 100 Ram Dr
Jefferson, IA 50129-2728 - Phone
- (515) 386-4107
- Fax
- (515) 386-2347
- NPI assigned
- Mar 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Gary R Trebert
- Title
- Ceo
- Phone
- (817) 359-2000
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Centers for Long Term Care of Iowa
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
100 Ram Dr
Jefferson, IA 50129-2728
Mailing address
PO Box 155635
Fort Worth, TX 76155-0635
Phone (817) 359-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0654277 | Medicaid | IA |
Other names
- CLC Jefferson
Other providers in Jefferson, IA
- Terry L Brown
- John Bryan Brunow
- Mark Francis Buettner
- Carroll Apothecary, Inc
- Maribel Castellanos
- Central Iowa Family Eyecare PLLC
- Columba Chukwubuikem Chukwuka
- Julie W. Clark
- Laurie Lynn Connolly
- County of Greene
All providers in Jefferson, IA · Skilled Nursing Facility in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.