Provider Demographics
NPI:1669532883
Name:SIGNATURE MANAGEMENT
Entity type:Organization
Organization Name:SIGNATURE MANAGEMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ASSISTED LIVING
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:FIER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:563-322-2718
Mailing Address - Street 1:332 N HARRISON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1309
Mailing Address - Country:US
Mailing Address - Phone:563-322-2718
Mailing Address - Fax:563-322-2721
Practice Address - Street 1:1607 W 12TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-4086
Practice Address - Country:US
Practice Address - Phone:563-323-3888
Practice Address - Fax:563-324-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0214310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0463604Medicaid