Healthcare Provider Details
I. General information
NPI: 1134085152
Provider Name (Legal Business Name): EMINENT HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160 DAKOTA CIR
WAUKEE IA
50263-7125
US
IV. Provider business mailing address
160 DAKOTA CIR
WAUKEE IA
50263-7125
US
V. Phone/Fax
- Phone: 515-200-9559
- Fax:
- Phone: 515-200-9559
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICTORIA
B
SONDE GUEH
Title or Position: OWNER
Credential: MA
Phone: 515-770-9704