Provider Demographics
NPI:1538219365
Name:AMERICAN BAPTIST HOMES OF THE MIDWEST
Entity type:Organization
Organization Name:AMERICAN BAPTIST HOMES OF THE MIDWEST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUDGET & FINANCE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWIGERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-331-1200
Mailing Address - Street 1:1409 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537-1937
Mailing Address - Country:US
Mailing Address - Phone:712-755-5178
Mailing Address - Fax:712-755-9408
Practice Address - Street 1:1409 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537-1937
Practice Address - Country:US
Practice Address - Phone:712-755-5178
Practice Address - Fax:712-755-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0172577Medicaid
IA0895946OtherSSA VENDOR #