- Enrollment id
- O20101202000016
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1467422907
- Multiple npi flag
- N
- Ccn
- 165329
- Associate id
- 3870575350
- Organization name
- CARE INITIATIVES
- Doing business as name
- KINGSLEY SPECIALTY CARE
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- KINGSLEY SPECIALTY CARE
- Affiliation entity name
- CARE INITIATIVES
- Affiliation entity id
- 106
- Address line 1
- 305 W 3RD ST
- Address line 2
- BOX 10
- City
- KINGSLEY
- State
- IA
- Zip code
- 510285064