Provider Demographics
NPI:1285628214
Name:TRAER NURSING CARE CENTER, INC.
Entity Type:Organization
Organization Name:TRAER NURSING CARE CENTER, INC.
Other - Org Name:SUNRISE HILL CARE & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-478-2730
Mailing Address - Street 1:909 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TRAER
Mailing Address - State:IA
Mailing Address - Zip Code:50675-1311
Mailing Address - Country:US
Mailing Address - Phone:319-478-2730
Mailing Address - Fax:319-478-2728
Practice Address - Street 1:909 6TH ST
Practice Address - Street 2:
Practice Address - City:TRAER
Practice Address - State:IA
Practice Address - Zip Code:50675-1311
Practice Address - Country:US
Practice Address - Phone:319-478-2730
Practice Address - Fax:319-478-2728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA860226261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0652867Medicaid