MEDICARE: ACCESS HABILITATION CENTER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1871443382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS HABILITATION CENTER LLC

Provider Business Mailing Address
First Line	:	1110 NE PRIMROSE LN UNIT 116
Second Line	:
City	:	GRIMES
State	:	IA
Zip	:	50111-6711
Country	:	US
Telephone Number	:	515-499-7565
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 NE PRIMROSE LN UNIT 116
Second Line	:
City	:	GRIMES
State	:	IA
Zip	:	50111-6711
Country	:	US
Telephone Number	:	515-499-7565
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NAOMIE BOWA
Credential	:
Telephone Number	:	515-499-7565

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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