- Enrollment id
- O20260129001012
- Enrollment state
- IA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1942092028
- Multiple npi flag
- N
- Ccn
- 165234
- Associate id
- 7618455973
- Organization name
- OPCO WELLMAN IA LLC
- Doing business as name
- PARKVIEW MANOR
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PARKVIEW MANOR
- Affiliation entity name
- CAMPBELL STREET SERVICES
- Affiliation entity id
- 99
- Address line 1
- 516 13TH ST
- City
- WELLMAN
- State
- IA
- Zip code
- 523569232