Provider Demographics
NPI:1497053581
Name:GRINNELL HEALTH CARE INVESTORS LLC
Entity Type:Organization
Organization Name:GRINNELL HEALTH CARE INVESTORS LLC
Other - Org Name:TRUREHAB OF GRINNELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-557-1190
Mailing Address - Street 1:415 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-8236
Mailing Address - Country:US
Mailing Address - Phone:641-236-6511
Mailing Address - Fax:641-236-6713
Practice Address - Street 1:415 6TH AVE W
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-8236
Practice Address - Country:US
Practice Address - Phone:641-236-6511
Practice Address - Fax:641-236-6713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165262Medicare Oscar/Certification