Basic Information
| Provider Information | |||||||||
| NPI: | 1528238243 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE MEADOWS ASSISTED LIVING | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1302 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CLARION | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505252091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5155322035 | ||||||||
| FaxNumber: | 5155323443 | ||||||||
| Practice Location | |||||||||
| Address1: | 1302 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CLARION | ||||||||
| State: | IA | ||||||||
| PostalCode: | 505252091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5155322035 | ||||||||
| FaxNumber: | 5155323443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2008 | ||||||||
| LastUpdateDate: | 03/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | KILEY | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR SERVICES DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5155326775 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WRIGHT MEDICAL FOUNDATION | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | S0225 | IA | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.