Healthcare Provider Details

I. General information

NPI: 1568983377
Provider Name (Legal Business Name): INTERCULTURAL CENTER OF IOWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 1ST AVE SE
CEDAR RAPIDS IA
52402-4403
US

IV. Provider business mailing address

3117 1ST AVE SE
CEDAR RAPIDS IA
52402-4403
US

V. Phone/Fax

Practice location:
  • Phone: 866-217-0429
  • Fax:
Mailing address:
  • Phone: 866-217-0429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management 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: RAMA MUZO
Title or Position: CEO
Credential:
Phone: 866-217-0429