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General NPI Number Information
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NPI Number | 1144178799
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Entity Type | Organization
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Legal Business Name | SUPPORTIVE HOME & COMMUNITY ASSISTED LIVING LLC
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 5062 GRANDVIEW AVE
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City | DES MOINES
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State | IA
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Zip | 50317-6048
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Country | US
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Telephone | 515-500-8050
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Fax |
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Provider Business Mailing Address
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Address Line | 5062 GRANDVIEW AVE
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City | DES MOINES
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State | IA
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Zip | 50317-6048
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Country | US
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Telephone | 804-616-1707
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ARNEAU MICHEL LEMOUPA FOKOU
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Credential |
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Telephone | 804-616-1707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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