Scottish Rite Park, Inc.

LBN: Scottish Rite Park, Inc.
Scottish Rite Park, Inc. is an health care organization with primary practice located at 2909 Woodland Ave. , Des Moines IA 50312. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Scottish Rite Park, Inc. can be contacted via phone (515) 274-4614, or through Allen, Mark William via phone (515) 202-2010.

Contact Information

Primary practice address
2909 Woodland Ave. Des Moines IA 50312
Phone: (515) 274-4614
Fax: (515) 274-6049
Website:
Map and Directions
Authorized official contact:
Name: Allen, Mark William
Phone: (515) 202-2010

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 770155 Iowa

Profile Details

NPI number 1679527840
LBN Legal business name Scottish Rite Park, Inc.
DBA Doing business as
Authorized official Allen, Mark William
Entity Organization
Organization subpart 1 No
Enumeration date May 20th, 2006
Last updated Sep 4th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679527840 NPPES
Iowa Other 16D0912082 CLIA
Iowa Other 770155 CLIA
Iowa MEDICAID 0800022 CLIA

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