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General NPI Number Information
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NPI Number | 1134313828
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARES HOME HEALTH, INC.
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 2511 PROSPECT RD
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City | DES MOINES
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State | IA
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Zip | 50310-6211
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Country | US
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Telephone | 515-277-1560
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Fax |
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Provider Business Mailing Address
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Address Line | 2511 PROSPECT RD
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City | DES MOINES
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State | IA
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Zip | 50310-6211
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Country | US
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Telephone | 515-277-1560
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS LAURA ROSE BREKKE
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Credential | RN, BSN
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Telephone | 515-277-1560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 113092
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License Number State | IA
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