Healthcare Provider Details

I. General information

NPI: 1124832720
Provider Name (Legal Business Name): PASADENA VILLA IOWA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 WESTOWN PKWY STE 120
WEST DES MOINES IA
50266-6717
US

IV. Provider business mailing address

720 COOL SPRINGS BLVD STE 550
FRANKLIN TN
37067-2645
US

V. Phone/Fax

Practice location:
  • Phone: 515-218-1225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN BRADY
Title or Position: CFO
Credential:
Phone: 615-864-8145