Provider Demographics
NPI:1396869830
Name:ADEL ASSISTED LIVING AND NURSING LLC
Entity type:Organization
Organization Name:ADEL ASSISTED LIVING AND NURSING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:515-993-4511
Mailing Address - Street 1:1919 GREENE STREET
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003
Mailing Address - Country:US
Mailing Address - Phone:515-993-4511
Mailing Address - Fax:515-993-3951
Practice Address - Street 1:1919 GREENE ST
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1636
Practice Address - Country:US
Practice Address - Phone:515-993-4511
Practice Address - Fax:515-993-3951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAN-229314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165555Medicare Oscar/Certification