Provider Demographics
NPI:1063750818
Name:ARLINGTON PLACE - POCAHONTAS
Entity type:Organization
Organization Name:ARLINGTON PLACE - POCAHONTAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:FULKERTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-335-3020
Mailing Address - Street 1:101 NE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:IA
Mailing Address - Zip Code:50574-2139
Mailing Address - Country:US
Mailing Address - Phone:712-335-3020
Mailing Address - Fax:712-335-5875
Practice Address - Street 1:101 NE 5TH ST
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:IA
Practice Address - Zip Code:50574-2139
Practice Address - Country:US
Practice Address - Phone:712-335-3020
Practice Address - Fax:712-335-5875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0226310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility