- Enrollment id
- O20260223001817
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1003707977
- Multiple npi flag
- N
- Ccn
- 165523
- Associate id
- 3779064332
- Organization name
- ESTHERVILLE OPCO LLC
- Doing business as name
- ESTHERVILLE COMMUNITY CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- ESTHERVILLE COMMUNITY CARE CENTER
- Address line 1
- 2001 1ST AVE N
- City
- ESTHERVILLE
- State
- IA
- Zip code
- 513342788