Basic Information
| Provider Information | |||||||||
| NPI: | 1699029322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BETTENDORF HEALTHCARE MANAGEMENT LLC | ||||||||
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| OtherOrganizationName: | BETTENDORF HEALTH CARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2730 CROW CREEK RD | ||||||||
| Address2: | |||||||||
| City: | BETTENDORF | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527222066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5633327463 | ||||||||
| FaxNumber: | 5633327464 | ||||||||
| Practice Location | |||||||||
| Address1: | 2730 CROW CREEK RD | ||||||||
| Address2: | |||||||||
| City: | BETTENDORF | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527222066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5633327463 | ||||||||
| FaxNumber: | 5633327464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2012 | ||||||||
| LastUpdateDate: | 12/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | BIENSTOCK | ||||||||
| AuthorizedOfficialFirstName: | JUDAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 3148122550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 820880 | IA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.