Provider Demographics
NPI:1023085909
Name:GRIFFIN NURSING CENTER INC
Entity type:Organization
Organization Name:GRIFFIN NURSING CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-842-2187
Mailing Address - Street 1:606 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-9577
Mailing Address - Country:US
Mailing Address - Phone:641-842-2187
Mailing Address - Fax:641-842-3527
Practice Address - Street 1:606 N 7TH ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-9577
Practice Address - Country:US
Practice Address - Phone:641-842-2187
Practice Address - Fax:641-842-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAN-389385H00000X
IA630389314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0807636Medicaid
IA0807636Medicaid