Provider Demographics
NPI:1922641992
Name:THE CLARE PROPCO LLC
Entity Type:Organization
Organization Name:THE CLARE PROPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP, TREASURER & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGEWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-875-4768
Mailing Address - Street 1:400 LOCUST ST STE 820
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2334
Mailing Address - Country:US
Mailing Address - Phone:515-875-4500
Mailing Address - Fax:515-875-4780
Practice Address - Street 1:55 E PEARSON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2535
Practice Address - Country:US
Practice Address - Phone:312-951-5690
Practice Address - Fax:312-784-8016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility