Provider Demographics
NPI:1881663276
Name:HEGG MEMORIAL HEALTH CENTER
Entity Type:Organization
Organization Name:HEGG MEMORIAL HEALTH CENTER
Other - Org Name:WHISPERING HEIGHTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEVENBERGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-476-8000
Mailing Address - Street 1:2116 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK VALLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51247-1422
Mailing Address - Country:US
Mailing Address - Phone:712-476-8200
Mailing Address - Fax:712-476-8290
Practice Address - Street 1:2116 14TH ST
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-1422
Practice Address - Country:US
Practice Address - Phone:712-476-8200
Practice Address - Fax:712-476-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA840049H313M00000X
IA0448654385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0804062Medicaid
IA16E637Medicaid
IA840049HOtherSTATE LICENSE NUMBER
IA840049HOtherSTATE LICENSE NUMBER