Healthcare Provider Details

I. General information

NPI: 1093647166
Provider Name (Legal Business Name): B.A. PERRY LEGACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 5TH AVE
DES MOINES IA
50313-4243
US

IV. Provider business mailing address

3310 5TH AVE
DES MOINES IA
50313-4243
US

V. Phone/Fax

Practice location:
  • Phone: 515-528-4745
  • Fax:
Mailing address:
  • Phone: 515-528-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: FLOANNA JO TEMPLE
Title or Position: OWNER
Credential:
Phone: 515-528-4745