Countryside Retirement Home, Inc.
LBN: Countryside Retirement Home Of Sioux City, Iowa
Countryside Retirement Home, Inc. is an health care organization with primary practice located at 6120 Morningside Ave , Sioux City IA 51106-3943. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Custodial Care Facility, Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty.
Countryside Retirement Home Of Sioux City, Iowa can be contacted via phone (712) 276-3000, or through Menzenberg, Debbie via phone (712) 276-3000.
Contact Information
Primary practice address
6120 Morningside Ave
Sioux City IA 51106-3943
Phone: (712) 276-3000
Fax: (712) 266-2167
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Custodial Care Facility | 311Z00000X | R-0370 | Iowa |
| Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility | 313M00000X | N-0370 | Iowa |
Profile Details
| NPI number | 1104825876 |
|---|---|
| LBN Legal business name | Countryside Retirement Home Of Sioux City, Iowa |
| DBA Doing business as | Countryside Retirement Home, Inc. |
| Authorized official | Menzenberg, Debbie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Sep 11th, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104825876 | NPPES |
| Iowa | MEDICAID | 0800300 |
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