FIVE STAR QUALITY CARE-IA INC. NPI 1558301606

NPI Information

NPI: 1558301606
Provider Name: FIVE STAR QUALITY CARE-IA, INC.

Doing Business As: PARK PLACE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
114 E GREEN ST
GLENWOOD, IA
ZIP 51534
Phone: (712) 527-4841
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FIVE STAR QUALITY CARE-IA, INC. is an intermediate care facility mentally retarded in Glenwood, IA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. FIVE STAR QUALITY CARE-IA, INC. NPI is 1558301606. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Place.

The provider's business location address is:

114 E GREEN ST
GLENWOOD, IA
ZIP 51534-902
Phone: (712) 527-4841
Fax: (712) 527-3377

The provider's authorized official is Bruce J. Mackey .
The authorized official title is President & Chief Executive Officer and has the following contact phone number (617) 796-8214.

The enumeration date for this NPI number is 6/7/2006 and was last updated on 4/22/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0881565	MEDICAID	IOWA

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: 5/5/2024

NPI Synchronization or Removal

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