| Organization Name: | THE ELLEN KENNEDY LIVING CENTER |
| NPI Number: | 1184837593 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KARI ANNE WITTMEYER (DIRECTOR) |
| Mailing Address: | 1177 7th St Sw Ste #1 Dyersville |
| State: | IA US |
| Postal Code: | 520402513 |
| Phone Number: | 5638756323 |
| Fax Number: | 5638756268 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | S0155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |