Provider Demographics
NPI:1497831754
Name:RUTHVEN COMMUNITY CARE CENTER INC
Entity Type:Organization
Organization Name:RUTHVEN COMMUNITY CARE CENTER INC
Other - Org Name:RUTHVEN COMMUNITY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-837-5411
Mailing Address - Street 1:2701 EAST MITCHELL
Mailing Address - Street 2:
Mailing Address - City:RUTHVEN
Mailing Address - State:IA
Mailing Address - Zip Code:51358
Mailing Address - Country:US
Mailing Address - Phone:712-837-5411
Mailing Address - Fax:712-837-5550
Practice Address - Street 1:2701 EAST MITCHELL
Practice Address - Street 2:
Practice Address - City:RUTHVEN
Practice Address - State:IA
Practice Address - Zip Code:51358
Practice Address - Country:US
Practice Address - Phone:712-837-5411
Practice Address - Fax:712-837-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0147310400000X
IA740213314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0147702Medicaid
IA65486OtherBCBS PROVIDER #
IA0807057Medicaid
IA0807057Medicaid