| Organization Name: | GOOD SHEPHERD GERIATRIC CENTER, INC. |
| NPI Number: | 1073688297 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANNE DEMARIS (BKPR) |
| Mailing Address: | 302 2nd St Ne Mason City |
| State: | IA US |
| Postal Code: | 504013412 |
| Phone Number: | 6414241740 |
| Fax Number: | |
| NPI Enumeration Date: | 11/22/2006 |
| NPI Last Update Date: | 11/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Adult Development & Aging |
| Taxonomy Definition: | |