Provider Demographics
NPI:1821092255
Name:HUBBARD CARE CENTER, INC.
Entity Type:Organization
Organization Name:HUBBARD CARE CENTER, INC.
Other - Org Name:HUBBARD CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUDA-BRUNS
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:641-864-3264
Mailing Address - Street 1:403 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:IA
Mailing Address - Zip Code:50122-9501
Mailing Address - Country:US
Mailing Address - Phone:641-864-3264
Mailing Address - Fax:641-864-2343
Practice Address - Street 1:403 S STATE ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:IA
Practice Address - Zip Code:50122-9501
Practice Address - Country:US
Practice Address - Phone:641-864-3264
Practice Address - Fax:641-864-2343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA420999313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0809434Medicaid
IA165335Medicare Oscar/Certification