Provider Demographics
NPI:1760077374
Name:EDENCREST TUSCANY, LLC
Entity Type:Organization
Organization Name:EDENCREST TUSCANY, LLC
Other - Org Name:EDENCREST AT TUSCANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMMUNITY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-681-1438
Mailing Address - Street 1:6900 WESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2520
Mailing Address - Country:US
Mailing Address - Phone:515-681-1438
Mailing Address - Fax:
Practice Address - Street 1:1600 8TH STREET SE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2520
Practice Address - Country:US
Practice Address - Phone:515-681-1438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility