- Enrollment id
- O20250502002307
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1174352108
- Multiple npi flag
- N
- Ccn
- 165173
- Associate id
- 2567990419
- Organization name
- OPCO OSAGE IA LLC
- Doing business as name
- OSAGE REHAB & HEALTH CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- OSAGE REHAB AND HEALTH CARE CENTER
- Affiliation entity name
- CAMPBELL STREET SERVICES
- Affiliation entity id
- 99
- Address line 1
- 830 SOUTH FIFTH STREET
- City
- OSAGE
- State
- IA
- Zip code
- 504611919