Provider Demographics
NPI:1285033605
Name:GRUNDY CARE CENTER, INC.
Entity Type:Organization
Organization Name:GRUNDY CARE CENTER, INC.
Other - Org Name:GRUNDY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAUNCEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:601-956-1013
Mailing Address - Street 1:102 E J AVE
Mailing Address - Street 2:
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-2031
Mailing Address - Country:US
Mailing Address - Phone:319-824-5436
Mailing Address - Fax:
Practice Address - Street 1:102 E J AVE
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-2031
Practice Address - Country:US
Practice Address - Phone:319-824-5436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAVERLEY - IOWA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility