Provider Demographics
NPI:1407922396
Name:BARTHELL OES HOME
Entity Type:Organization
Organization Name:BARTHELL OES HOME
Other - Org Name:ARLIN FALCK ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:T
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:563-382-8777
Mailing Address - Street 1:911 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2354
Mailing Address - Country:US
Mailing Address - Phone:563-382-8777
Mailing Address - Fax:563-382-8788
Practice Address - Street 1:911 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2354
Practice Address - Country:US
Practice Address - Phone:563-382-8777
Practice Address - Fax:563-382-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS 0081310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAS 0081OtherCERT