Provider Demographics
NPI:1043375769
Name:ON WITH LIFE, INC.
Entity Type:Organization
Organization Name:ON WITH LIFE, INC.
Other - Org Name:ON WITH LIFE AT ANKENY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUFT-WISKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-289-9703
Mailing Address - Street 1:715 SW ANKENY RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9798
Mailing Address - Country:US
Mailing Address - Phone:515-289-9658
Mailing Address - Fax:515-965-1186
Practice Address - Street 1:715 SW ANKENY RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9798
Practice Address - Country:US
Practice Address - Phone:515-965-1339
Practice Address - Fax:515-965-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA770700314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA65163OtherBLUE CROSS BLUE SHIELD
NE100249Medicaid
IA7100081OtherUNITED HEALTH CARE
IA0651638Medicaid
IA0651638Medicaid
IA=========OtherFIRST ADMINISTRATORS
IA165163Medicare ID - Type UnspecifiedMEDICARE