- Enrollment id
- O20260203000347
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1154113454
- Multiple npi flag
- N
- Ccn
- 165399
- Associate id
- 4880172667
- Organization name
- OPCO HIGH ROAD NORWALK IA LLC
- Doing business as name
- REGENCY CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- REGENCY CARE CENTER
- Affiliation entity name
- CAMPBELL STREET SERVICES
- Affiliation entity id
- 99
- Address line 1
- 815 HIGH RD
- City
- NORWALK
- State
- IA
- Zip code
- 502111462