Provider Demographics
NPI:1073717153
Name:MAYFLOWER HOMES, INC.
Entity Type:Organization
Organization Name:MAYFLOWER HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-236-6151
Mailing Address - Street 1:616 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-2298
Mailing Address - Country:US
Mailing Address - Phone:641-236-6151
Mailing Address - Fax:641-236-6154
Practice Address - Street 1:616 BROAD ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2298
Practice Address - Country:US
Practice Address - Phone:641-236-6151
Practice Address - Fax:641-236-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAI-277310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0204149OtherRCF & ELDERLY WAIVER PROV
IA0893347Medicaid
IA0893347Medicaid