Eastern Star Masonic Home

LBN: Eastern Star Masonic Home
Eastern Star Masonic Home is an health care organization with primary practice located at 715 W Mamie Eisenhower Ave , Boone IA 50036-3930. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Custodial Care Facility, Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty. Eastern Star Masonic Home can be contacted via phone (515) 432-5274, or through Armstrong, Scott Dylan via phone (515) 709-4398.

Contact Information

Primary practice address
715 W Mamie Eisenhower Ave Boone IA 50036-3930
Phone: (515) 432-5274
Fax: (515) 432-5276
Website:
Map and Directions
Authorized official contact:
Name: Armstrong, Scott Dylan
Phone: (515) 709-4398

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Custodial Care Facility 311Z00000X R-268 Iowa
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X N-0268 Iowa
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X N-0268 Iowa

Profile Details

NPI number 1740283795
LBN Legal business name Eastern Star Masonic Home
DBA Doing business as
Authorized official Armstrong, Scott Dylan
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2005
Last updated Mar 5th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740283795 NPPES
Iowa MEDICAID 0890210
Iowa MEDICAID 0801076

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