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General NPI Number Information
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NPI Number | 1891137436
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Entity Type | Organization
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Legal Business Name | AMERICARE SUPPORT SERVICES
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 2009 320TH AVE
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City | SIDNEY
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State | IA
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Zip | 51652-6059
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Country | US
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Telephone | 712-350-0768
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 320TH AVE PO BOX 552
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City | SIDNEY
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State | IA
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Zip | 51652-6059
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Country | US
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Telephone | 712-350-0768
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DONALD JOEY SHIPLEY
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Credential | RN
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Telephone | 712-350-0768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 122561
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License Number State | IA
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