Healthcare Provider Details

I. General information

NPI: 1538560602
Provider Name (Legal Business Name): HUMAN CODE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 1ST AVE SE STE 105-164
CEDAR RAPIDS IA
52402-3251
US

IV. Provider business mailing address

5001 1ST AVE SE STE 105-164
CEDAR RAPIDS IA
52402-3251
US

V. Phone/Fax

Practice location:
  • Phone: 319-213-7822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRIAN PEDDER
Title or Position: CEO
Credential:
Phone: 319-213-7822