Healthcare Provider Details

I. General information

NPI: 1043902364
Provider Name (Legal Business Name): IOWA COMPASS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14014 BUENA VISTA DR
URBANDALE IA
50323-2132
US

IV. Provider business mailing address

14014 BUENA VISTA DR
URBANDALE IA
50323-2132
US

V. Phone/Fax

Practice location:
  • Phone: 515-556-0391
  • Fax:
Mailing address:
  • Phone: 515-556-0391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: KENNEDY KIPROP
Title or Position: MANAGING DIRECTOR
Credential: RN
Phone: 515-556-0394