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MARTIN LUTHER HOME CORPORATION NPI 1508850512


NPI Information

NPI: 1508850512
Provider Name: MARTIN LUTHER HOME CORPORATION

Doing Business As: LUTHER MANOR RETIREMENT HOME

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 16D2202161

Address:
3131 HILLCREST RD
DUBUQUE, IA
ZIP 52001
Phone: (563) 588-1413
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MARTIN LUTHER HOME CORPORATION is a nursing facility intermediate care facility in Dubuque, IA. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. MARTIN LUTHER HOME CORPORATION NPI is 1508850512. The provider is registered as an organization entity type.
The provider Is Doing Business As Luther Manor Retirement Home.

The provider's business location address is:

3131 HILLCREST RD
DUBUQUE, IA
ZIP 52001
Phone: (563) 588-1413
Fax: (563) 588-2770

The provider's authorized official is Kim Harkey .
The authorized official title is Administrator and has the following contact phone number (563) 690-6628.

The CLIA number assigned to this NPI record is 16D2202161 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/6/2005 and was last updated on 3/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1253Z00000XIn Home Supportive CareNo
2311500000XAlzheimer Center (Dementia Center)NF-452IOWANo
3314000000XSkilled Nursing FacilityNF-452IOWANo
4313M00000XNursing Facility/Intermediate Care FacilityNF-452IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10802280MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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