Provider Demographics
NPI:1821299850
Name:URBANDALE ASSISTED LIVING, L.P.
Entity Type:Organization
Organization Name:URBANDALE ASSISTED LIVING, L.P.
Other - Org Name:SENIOR SUITES OF URBANDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CRRN
Authorized Official - Phone:515-270-9700
Mailing Address - Street 1:4700 84TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7352
Mailing Address - Country:US
Mailing Address - Phone:515-270-9700
Mailing Address - Fax:515-270-9582
Practice Address - Street 1:4700 84TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7352
Practice Address - Country:US
Practice Address - Phone:515-270-9700
Practice Address - Fax:515-270-9582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0098310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0441840OtherELDERLY WAIVER SERVICES