- Enrollment id
- O20251209001145
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1053140111
- Multiple npi flag
- N
- Ccn
- 165198
- Associate id
- 5496284135
- Organization name
- OPCO IOWA CITY IA LLC
- Doing business as name
- IOWA CITY REHAB & HEALTH CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- IOWA CITY REHAB & HEALTH CARE
- Affiliation entity name
- CAMPBELL STREET SERVICES
- Affiliation entity id
- 99
- Address line 1
- 3661 ROCHESTER AVENUE
- City
- IOWA CITY
- State
- IA
- Zip code
- 522459271