- Enrollment id
- O20250822001560
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1912736653
- Multiple npi flag
- N
- Ccn
- 165531
- Associate id
- 4688174824
- Organization name
- OPCO SHENANDOAH IA LLC
- Doing business as name
- GARDEN VIEW CARE CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GARDEN VIEW CARE CENTER
- Affiliation entity name
- CAMPBELL STREET SERVICES
- Affiliation entity id
- 99
- Address line 1
- 1200 W NISHNA RD
- City
- SHENANDOAH
- State
- IA
- Zip code
- 516012116