Provider Demographics
NPI:1013904432
Name:BARTELS LUTHERAN HOME
Entity Type:Organization
Organization Name:BARTELS LUTHERAN HOME
Other - Org Name:BARTELS LUTHERAN RETIREMENT COMMUNITY / WOODLAND TERRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-352-4540
Mailing Address - Street 1:1922 5TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-1903
Mailing Address - Country:US
Mailing Address - Phone:319-352-4540
Mailing Address - Fax:319-352-2161
Practice Address - Street 1:1922 5TH AVE NW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-1903
Practice Address - Country:US
Practice Address - Phone:319-352-4540
Practice Address - Fax:319-352-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
090286311500000X
IA090286313M00000X
IA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No253Z00000XAgenciesIn Home Supportive Care
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0800169Medicaid
IA165442Medicare Oscar/Certification