Organization · Type 2 NPI

Countryside Retirement Home of Sioux City, Iowa

Nursing Facility/Intermediate Care Facility · Sioux City, IA

NPI number 1104825876 Active

Practice location

6120 Morningside Ave
Sioux City, IA 51106-3943

Fax (712) 266-2167

Specialties and licenses

Taxonomy	Code	License
Custodial Care Facility	311Z00000X	R-0370 (IA)
Nursing Facility/Intermediate Care Facility Primary	313M00000X	N-0370 (IA)

Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…

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About NPI 1104825876

Countryside Retirement Home of Sioux City, Iowa's National Provider Identifier is 1104825876, issued on Jul 15, 2005. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in Sioux City, IA. The record was last updated on Sep 11, 2009.