Provider Demographics
NPI:1891539656
Name:ISAAC CARE
Entity type:Organization
Organization Name:ISAAC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:NIYONKURU
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-209-2847
Mailing Address - Street 1:4410 NE RIO CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4912
Mailing Address - Country:US
Mailing Address - Phone:503-209-2847
Mailing Address - Fax:
Practice Address - Street 1:4410 NE RIO CT
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-4912
Practice Address - Country:US
Practice Address - Phone:503-209-2847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care