Provider Demographics
NPI:1114916749
Name:ENGLISH VALLEY NURSING CARE CENTER INC
Entity Type:Organization
Organization Name:ENGLISH VALLEY NURSING CARE CENTER INC
Other - Org Name:ENGLISH VALLEY NURSING CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-664-3256
Mailing Address - Street 1:150 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ENGLISH
Mailing Address - State:IA
Mailing Address - Zip Code:52316-9514
Mailing Address - Country:US
Mailing Address - Phone:319-664-3256
Mailing Address - Fax:319-664-3875
Practice Address - Street 1:150 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORTH ENGLISH
Practice Address - State:IA
Practice Address - Zip Code:52316-9514
Practice Address - Country:US
Practice Address - Phone:319-664-3256
Practice Address - Fax:319-664-3875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA480239314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0801175Medicaid
IA0801175Medicaid