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COUNTRYSIDE RETIREMENT HOME OF SIOUX CITY, IOWA

Custodial Care Facility

Sioux City, Iowa

Provider NPI: 1104825876

Organization Information:
Organization Name:  COUNTRYSIDE RETIREMENT HOME OF SIOUX CITY, IOWA


Practice Location:
6120 MORNINGSIDE AVE  SIOUX CITY, IA 51106 US
Tel: 712-276-3000  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311Z00000XNursing & Custodial Care Facilities
Custodial Care Facility
IAR-0370
Y313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
IAN-0370

Other Provider Identifiers:

IssuerNumberStateType
0800300IA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




CUSTODIAL CARE JOBS IA - Page 1