Provider Demographics
NPI:1205907748
Name:PLEASANT CARE PARTNERS LLP
Entity type:Organization
Organization Name:PLEASANT CARE PARTNERS LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-338-7912
Mailing Address - Street 1:605 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2121
Mailing Address - Country:US
Mailing Address - Phone:319-338-7912
Mailing Address - Fax:319-351-9225
Practice Address - Street 1:605 GREENWOOD DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2121
Practice Address - Country:US
Practice Address - Phone:319-325-3316
Practice Address - Fax:319-351-9225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA520101385H00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0804526Medicaid
IA0449355Medicaid
IA65172OtherBCBS PROVIDER #
IA0804526Medicaid