Healthcare Provider Details

I. General information

NPI: 1821969593
Provider Name (Legal Business Name): IOWA HAVEN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 42ND ST STE 147
WEST DES MOINES IA
50266-1005
US

IV. Provider business mailing address

1501 42ND ST STE 147
WEST DES MOINES IA
50266-1005
US

V. Phone/Fax

Practice location:
  • Phone: 515-204-1876
  • Fax:
Mailing address:
  • Phone: 515-204-1876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH KAHIU NGUNDO
Title or Position: ADMINISTRATOR
Credential:
Phone: 515-204-1876