Provider Demographics
NPI:1114097995
Name:ADEL ACRES CARE CENTER
Entity Type:Organization
Organization Name:ADEL ACRES CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-993-4511
Mailing Address - Street 1:1919 GREENE STR
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-1636
Mailing Address - Country:US
Mailing Address - Phone:515-993-4511
Mailing Address - Fax:515-993-3951
Practice Address - Street 1:1919 GREENE STR
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:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0229314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0800029Medicaid
IA0800029Medicaid