Healthcare Provider Details

I. General information

NPI: 1902814536
Provider Name (Legal Business Name): CAREGIVERS IOWA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 40TH ST NE
CEDAR RAPIDS IA
52402-5613
US

IV. Provider business mailing address

139 40TH ST NE
CEDAR RAPIDS IA
52402-5613
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-3318
  • Fax:
Mailing address:
  • Phone: 319-363-3318
  • 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:

# 1
Identifier0672253
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 2
Identifier67225
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerBCBS

VIII. Authorized Official

Name: MS. JENNIE FISHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 319-363-3318