Shady Oaks

LBN: Manor Of Lake City, Inc
Shady Oaks is an health care organization with primary practice located at 1409 W Main St , Lake City IA 51449-1578. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Manor Of Lake City, Inc can be contacted via phone (712) 464-3106, or through Vetter, Jack Dean via phone (402) 895-3932.

Contact Information

Primary practice address
1409 W Main St Lake City IA 51449-1578
Phone: (712) 464-3106
Fax: (712) 464-8042
Website:
Map and Directions
Authorized official contact:
Name: Vetter, Jack Dean
Phone: (402) 895-3932

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 130137 Iowa

Profile Details

NPI number 1962510859
LBN Legal business name Manor Of Lake City, Inc
DBA Doing business as Shady Oaks
Authorized official Vetter, Jack Dean
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2006
Last updated Aug 22nd, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962510859 NPPES
Iowa MEDICAID 807644

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