Healthcare Provider Details

I. General information

NPI: 1689184244
Provider Name (Legal Business Name): SH HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 1ST AVE NE
CEDAR RAPIDS IA
52402-4945
US

IV. Provider business mailing address

2616 1ST AVE NE
CEDAR RAPIDS IA
52402-4945
US

V. Phone/Fax

Practice location:
  • Phone: 319-826-6608
  • Fax: 319-826-6611
Mailing address:
  • Phone: 319-826-6608
  • Fax: 319-826-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateIA

VIII. Authorized Official

Name: STEPHANIE RAE HUMPHRIES
Title or Position: OWNER
Credential: MPT
Phone: 319-826-6608