Provider Demographics
NPI:1871755140
Name:CONTINUING CARE HOSPITAL AT ST LUKES
Entity type:Organization
Organization Name:CONTINUING CARE HOSPITAL AT ST LUKES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / BOARD OF MANAGERS
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-369-8873
Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-369-8142
Mailing Address - Fax:319-369-8105
Practice Address - Street 1:1026 A AVE NE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5036
Practice Address - Country:US
Practice Address - Phone:319-369-8142
Practice Address - Fax:319-369-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA570156H282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
162002Medicare Oscar/Certification