Healthcare Provider Details

I. General information

NPI: 1427537026
Provider Name (Legal Business Name): AMAZING KIDS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 N 11TH STREET PL
ADEL IA
50003
US

IV. Provider business mailing address

427 N 11TH STREET PL
ADEL IA
50003-1105
US

V. Phone/Fax

Practice location:
  • Phone: 515-478-1113
  • Fax:
Mailing address:
  • Phone: 515-478-1113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ERIC WESTBERG
Title or Position: OWNER
Credential:
Phone: 515-490-1999