Provider Demographics
NPI:1346214087
Name:CAREAGE MANAGEMENT LLC
Entity type:Organization
Organization Name:CAREAGE MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-293-0117
Mailing Address - Street 1:203 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:IA
Mailing Address - Zip Code:50597
Mailing Address - Country:US
Mailing Address - Phone:712-293-0117
Mailing Address - Fax:712-293-0356
Practice Address - Street 1:203 4TH ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:IA
Practice Address - Zip Code:50597
Practice Address - Country:US
Practice Address - Phone:515-887-4071
Practice Address - Fax:515-887-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA740851314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0805275Medicaid
IA165444Medicare Oscar/Certification
IA3961190004Medicare NSC