Provider Demographics
NPI:1972807170
Name:IOWA HOME CARE LLC
Entity type:Organization
Organization Name:IOWA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, CHCE
Authorized Official - Phone:515-222-2285
Mailing Address - Street 1:2500 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1420
Mailing Address - Country:US
Mailing Address - Phone:515-222-2285
Mailing Address - Fax:515-225-6777
Practice Address - Street 1:3 N 17TH ST STE B
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4211
Practice Address - Country:US
Practice Address - Phone:515-576-2273
Practice Address - Fax:515-576-2989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IOWA HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-03
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA167320Medicare Oscar/Certification