Healthcare Provider Details

I. General information

NPI: 1235101817
Provider Name (Legal Business Name): CARE INITIATIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E SOUTH ST
MANLY IA
50456-5058
US

IV. Provider business mailing address

1611 W LAKES PKWY
WEST DES MOINES IA
50266-8212
US

V. Phone/Fax

Practice location:
  • Phone: 641-454-2223
  • Fax: 641-454-2124
Mailing address:
  • Phone: 515-224-4442
  • Fax: 515-224-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number980352
License Number StateIA

VII. Legacy identifiers

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

# 1
Identifier0414458
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 2
Identifier0652263
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 3
Identifier0808196
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: DAVID DIXON
Title or Position: MANAGED CARE COORDINATOR
Credential:
Phone: 515-224-4442