Five Star Quality Care-Ia, LLC
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Pacific Junction, IA
NPI 1881640993 · NPPES record last updated May 29, 2008
Key facts
- NPI
- 1881640993
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- Legal business name
- FIVE STAR QUALITY CARE-IA, LLC
- Practice address
- 20937 Kane Ave
Pacific Junction, IA 51561-4242 - Phone
- (712) 622-8144
- Fax
- (712) 622-8158
- NPI assigned
- May 26, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- FIVE STAR QUALITY CARE-IA, LLC
Authorized official
- Name
- Bruce J Mackey Jr.
- Title
- Ceo
- Phone
- (617) 796-8387
National Provider Directory
- Part of
- Five Star Quality Care Ia LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Yes |
Addresses
Primary practice location
20937 Kane Ave
Pacific Junction, IA 51561-4242
Mailing address
400 Centre St
Newton, MA 02458-2094
Phone (617) 796-8387
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0881573 | Medicaid | IA |
Other names
- Pacific Place
Other providers in Pacific Junction, IA
- City of Pacific Junction
- Tamara Cruz
- Angelica Cusay
- Emotional Balance, LLC
- Ninkpibe Kezia Gnofam
- Crystal Dell Morton
- Seraphis
- Seraphis
All providers in Pacific Junction, IA · Intellectual Disabilities Intermediate Care 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 May 29, 2008. 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.