MEDICARE: DAE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1427371665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAE, INC.

Provider Business Mailing Address
First Line	:	11623 ARBOR ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68144-2981
Country	:	US
Telephone Number	:	402-334-1919
Fax Number	:	402-334-6844

Provider Business Practice Location Address
First Line	:	402 W BURLINGTON AVE STE 200
Second Line	:
City	:	FAIRFIELD
State	:	IA
Zip	:	52556-3243
Country	:	US
Telephone Number	:	641-469-3130
Fax Number	:	641-243-4884

Authorized Official
Title or Position	:	CLINIC ADMIN DIRECTOR
Name	:	THERESA LYNN GODFREY
Credential	:
Telephone Number	:	402-334-6025

Provider Enumeration Date	:	03/02/2010
Last Update Date	:	11/06/2024

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Directions to “DAE, INC. ” Practice Location

Language	Start Address	Practice Location

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