Provider Demographics
NPI:1982647053
Name:PPRC, LLC
Entity Type:Organization
Organization Name:PPRC, LLC
Other - Org Name:GARDEN VIEW PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-360-4863
Mailing Address - Street 1:800 DARBY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:IA
Mailing Address - Zip Code:52159
Mailing Address - Country:US
Mailing Address - Phone:563-794-4628
Mailing Address - Fax:
Practice Address - Street 1:800 DARBY DRIVE
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:IA
Practice Address - Zip Code:52159
Practice Address - Country:US
Practice Address - Phone:563-794-4628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAALPC S0215310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAALPC S0215OtherALPC