MEDICARE: IOWA HAVEN HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	253Z00000X	In Home Supportive Care Agency
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1821969593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IOWA HAVEN HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1501 42ND ST STE 147
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1005
Country	:	US
Telephone Number	:	515-204-1876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 42ND ST STE 147
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1005
Country	:	US
Telephone Number	:	515-204-1876
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. KENNETH KAHIU NGUNDO
Credential	:
Telephone Number	:	515-204-1876

Provider Enumeration Date	:	09/16/2025
Last Update Date	:	03/17/2026

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