Provider Demographics
NPI:1053338566
Name:STRAWBERRY POINT LUTHERAN HOME FOR THE AGED
Entity type:Organization
Organization Name:STRAWBERRY POINT LUTHERAN HOME FOR THE AGED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:563-933-6037
Mailing Address - Street 1:313 ELKADER ST.
Mailing Address - Street 2:P.O. BOX 34
Mailing Address - City:STRAWBERRY PT.
Mailing Address - State:IA
Mailing Address - Zip Code:52076-0034
Mailing Address - Country:US
Mailing Address - Phone:563-933-6037
Mailing Address - Fax:563-933-2204
Practice Address - Street 1:313 ELKADER ST.
Practice Address - Street 2:
Practice Address - City:STRAWBERRY PT.
Practice Address - State:IA
Practice Address - Zip Code:52076-0034
Practice Address - Country:US
Practice Address - Phone:563-933-6037
Practice Address - Fax:563-933-2204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA220344311500000X, 313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36443546OtherVETERANS ADMINSTRATION
IA0802314Medicaid
IA0802314Medicaid