Healthcare Provider Details

I. General information

NPI: 1295676930
Provider Name (Legal Business Name): UNITED HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6367 VISTA DR APT 6100
WEST DES MOINES IA
50266-5530
US

IV. Provider business mailing address

6367 VISTA DR APT 6100
WEST DES MOINES IA
50266-5530
US

V. Phone/Fax

Practice location:
  • Phone: 806-683-7104
  • Fax:
Mailing address:
  • Phone: 806-683-7104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JEAN CLAUDE NGIRAKWIZERA
Title or Position: MANAGING MEMBER
Credential:
Phone: 806-683-7104