Provider Demographics
NPI:1376309070
Name:AL OF BAVARIAN MEADOWS, INC.
Entity Type:Organization
Organization Name:AL OF BAVARIAN MEADOWS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-594-1062
Mailing Address - Street 1:632 L 14
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:IA
Mailing Address - Zip Code:51050
Mailing Address - Country:US
Mailing Address - Phone:712-786-1660
Mailing Address - Fax:712-786-1664
Practice Address - Street 1:632 L 14
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:IA
Practice Address - Zip Code:51050
Practice Address - Country:US
Practice Address - Phone:712-786-1660
Practice Address - Fax:712-786-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility