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LEGACY HOUSE LLC

Adult Care Home

Indianola, Iowa

Provider NPI: 1871640144

Organization Information:
Organization Name:  LEGACY HOUSE LLC


Practice Location:
207 E SALEM AVE  INDIANOLA, IA 50125 US
Tel: 515-961-5245  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
IA910498

Other Provider Identifiers:

IssuerNumberStateType
0896761IA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS IA - Page 1