Provider Demographics
NPI:1467459073
Name:CLARION HEALTH CARE
Entity Type:Organization
Organization Name:CLARION HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-532-2893
Mailing Address - Street 1:110 13TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2004
Mailing Address - Country:US
Mailing Address - Phone:515-532-2893
Mailing Address - Fax:515-532-2782
Practice Address - Street 1:110 13TH AVE SW
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2004
Practice Address - Country:US
Practice Address - Phone:515-532-2893
Practice Address - Fax:515-532-2782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA990752314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA65362OtherBCBS PROVIDER#
IA0804914Medicaid
IA0804914Medicaid