Healthcare Provider Details

I. General information

NPI: 1811541121
Provider Name (Legal Business Name): REM IOWA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 06/23/2024
Certification Date: 06/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 33RD AVE SW
CEDAR RAPIDS IA
52404
US

IV. Provider business mailing address

1220 INDUSTRIAL AVE STE C
HIAWATHA IA
52233-1118
US

V. Phone/Fax

Practice location:
  • Phone: 319-393-1944
  • Fax: 319-393-2091
Mailing address:
  • Phone: 319-393-1944
  • Fax: 319-393-2091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
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: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: VP & SR ASST GENERAL COUNSEL
Credential:
Phone: 952-836-2234