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General NPI Number Information
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NPI Number | 1699399642
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Entity Type | Organization
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Legal Business Name | DAVENPORT IOWA HOMECARE LLC
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 1895 MIDDLE ROAD SUITE 201
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City | BETTENDORF
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State | IA
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Zip | 52722-7601
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Country | US
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Telephone | 309-781-0499
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Fax |
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Provider Business Mailing Address
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Address Line | 1895 MIDDLE ROAD SUITE 201
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City | BETTENDORF
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State | IA
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Zip | 52722-7601
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Country | US
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Telephone | 309-781-0499
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. BETSEY ANN MORTHLAND
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Credential | PHD
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Telephone | 309-781-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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