- Enrollment id
- O20190924000044
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1649831678
- Multiple npi flag
- N
- Ccn
- 165158
- Associate id
- 4082944798
- Organization name
- BCP CLARINDA LLC
- Doing business as name
- AZRIA HEALTH CLARINDA
- Incorporation date
- 2019-06-19
- Incorporation state
- IA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- AZRIA HEALTH CLARINDA
- Affiliation entity name
- AZRIA HEALTH
- Affiliation entity id
- 64
- Address line 1
- 600 MANOR DR
- City
- CLARINDA
- State
- IA
- Zip code
- 516322444