Clover Ridge Place

LBN: Ehlers Lane Lc
Clover Ridge Place is an health care organization with primary practice located at 205 Ehlers Ln , Maquoketa IA 52060-9615. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Ehlers Lane Lc can be contacted via phone (563) 652-2125, or through Popp, Lynne via phone (563) 652-2125.

Contact Information

Primary practice address
205 Ehlers Ln Maquoketa IA 52060-9615
Phone: (563) 652-2125
Fax: (563) 652-0145
Website:
Map and Directions
Authorized official contact:
Name: Popp, Lynne SW
Phone: (563) 652-2125

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X S0078 Iowa

Profile Details

NPI number 1245443928
LBN Legal business name Ehlers Lane Lc
DBA Doing business as Clover Ridge Place
Authorized official Popp, Lynne SW
Entity Organization
Organization subpart 1 No
Enumeration date May 8th, 2007
Last updated Jun 11th, 2008 - about 18 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 1245443928 NPPES
Iowa MEDICAID 0275073

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