Provider Demographics
NPI:1871523027
Name:CHRISTIAN RETIREMENT SERVICES INC
Entity type:Organization
Organization Name:CHRISTIAN RETIREMENT SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-466-3006
Mailing Address - Street 1:1 OAKNOLL CT
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-5250
Mailing Address - Country:US
Mailing Address - Phone:319-351-1720
Mailing Address - Fax:319-351-6772
Practice Address - Street 1:1 OAKNOLL CT
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-5250
Practice Address - Country:US
Practice Address - Phone:319-351-1720
Practice Address - Fax:319-351-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAN402310400000X
IA520402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0802975Medicaid
65030OtherWELLMARK BCBS
IA0802975Medicaid