Healthcare Provider Details

I. General information

NPI: 1821262114
Provider Name (Legal Business Name): RESCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 04/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 AVENUE F
FORT MADISON IA
52627-2910
US

IV. Provider business mailing address

301 W BURLINGTON AVE
FAIRFIELD IA
52556-3242
US

V. Phone/Fax

Practice location:
  • Phone: 319-372-3566
  • Fax: 319-372-8074
Mailing address:
  • Phone: 641-472-1684
  • Fax: 641-472-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCMHC
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ROD HOTEK
Title or Position: CEO
Credential: CEO
Phone: 641-472-1684