Provider Demographics
NPI:1144765561
Name:ESTHERVILLE AL WINDSOR MANOR
Entity Type:Organization
Organization Name:ESTHERVILLE AL WINDSOR MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:M
Authorized Official - Last Name:YOULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-362-0171
Mailing Address - Street 1:2015 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-1740
Mailing Address - Country:US
Mailing Address - Phone:712-362-0171
Mailing Address - Fax:712-362-0034
Practice Address - Street 1:2015 3RD AVE N
Practice Address - Street 2:
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-1740
Practice Address - Country:US
Practice Address - Phone:712-362-0171
Practice Address - Fax:712-362-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0352310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility