Provider Demographics
NPI:1538374178
Name:ARLINGTON PLACE OF GRUNDY CENTER
Entity type:Organization
Organization Name:ARLINGTON PLACE OF GRUNDY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOUSING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-824-5674
Mailing Address - Street 1:95 D AVE
Mailing Address - Street 2:
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-1950
Mailing Address - Country:US
Mailing Address - Phone:319-824-5674
Mailing Address - Fax:319-824-5676
Practice Address - Street 1:95 D AVE
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-1950
Practice Address - Country:US
Practice Address - Phone:319-824-5674
Practice Address - Fax:319-824-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0112305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0230490Medicaid