Healthcare Provider Details

I. General information

NPI: 1871428128
Provider Name (Legal Business Name): NOVACARE SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 E COURT ST
IOWA CITY IA
52245-3963
US

IV. Provider business mailing address

5249 N PARK PL NE UNIT 2245
CEDAR RAPIDS IA
52402-6210
US

V. Phone/Fax

Practice location:
  • Phone: 402-871-1436
  • Fax:
Mailing address:
  • Phone: 402-871-1436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SOM BEEME S NONGUIERMA
Title or Position: OWNER
Credential:
Phone: 712-219-2719