FIVE STAR QUALITY CARE-IA LLC NPI 1881640993

NPI Information

NPI: 1881640993
Provider Name: FIVE STAR QUALITY CARE-IA, LLC

Doing Business As: PACIFIC PLACE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
20937 KANE AVE
PACIFIC JUNCTION, IA
ZIP 51561
Phone: (712) 622-8144
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FIVE STAR QUALITY CARE-IA, LLC is an intermediate care facility mentally retarded in Pacific Junction, IA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. FIVE STAR QUALITY CARE-IA, LLC NPI is 1881640993. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacific Place.

The provider's business location address is:

20937 KANE AVE
PACIFIC JUNCTION, IA
ZIP 51561-242
Phone: (712) 622-8144
Fax: (712) 622-8158

The provider's authorized official is Bruce J Mackey .
The authorized official title is Ceo and has the following contact phone number (617) 796-8387.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 5/29/2008.

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	0881573	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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