Provider Demographics
NPI:1376998161
Name:ABCM CORPORATION
Entity Type:Organization
Organization Name:ABCM CORPORATION
Other - Org Name:ONEOTA VILLAGE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-456-5636
Mailing Address - Street 1:1320 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:IA
Mailing Address - Zip Code:50441-1104
Mailing Address - Country:US
Mailing Address - Phone:641-456-5636
Mailing Address - Fax:641-456-2320
Practice Address - Street 1:5 OHIO ST
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-1529
Practice Address - Country:US
Practice Address - Phone:563-382-1865
Practice Address - Fax:563-382-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility