Healthcare Provider Details

I. General information

NPI: 1467413609
Provider Name (Legal Business Name): CAREAGE OF NEWTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 W 18TH ST S
NEWTON IA
50208-5603
US

IV. Provider business mailing address

2130 W 18TH ST S
NEWTON IA
50208-5603
US

V. Phone/Fax

Practice location:
  • Phone: 641-791-1127
  • Fax: 641-791-2540
Mailing address:
  • Phone: 641-791-1127
  • Fax: 641-791-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number500607
License Number StateIA

VII. Legacy identifiers

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

# 1
Identifier0805093
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: MICHELLE ZIMBELMAN
Title or Position: MANAGER
Credential:
Phone: 816-232-9573