Provider Demographics
NPI:1023401916
Name:MARTIN LUTHER HOME CORPORATION
Entity Type:Organization
Organization Name:MARTIN LUTHER HOME CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:563-588-1145
Mailing Address - Street 1:3131 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-3908
Mailing Address - Country:US
Mailing Address - Phone:563-588-1145
Mailing Address - Fax:563-588-3875
Practice Address - Street 1:3131 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3908
Practice Address - Country:US
Practice Address - Phone:563-588-1145
Practice Address - Fax:563-588-3875
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARTIN LUTHER HOME CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-17
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health