Provider Demographics
NPI:1073586103
Name:CARE INITIATIVES
Entity Type:Organization
Organization Name:CARE INITIATIVES
Other - Org Name:WAPELLO SPECIALTY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/SVP
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-224-4442
Mailing Address - Street 1:1611 W LAKES PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8212
Mailing Address - Country:US
Mailing Address - Phone:515-224-4442
Mailing Address - Fax:515-224-0960
Practice Address - Street 1:601 HIGHWAY 61 S
Practice Address - Street 2:
Practice Address - City:WAPELLO
Practice Address - State:IA
Practice Address - Zip Code:52653-1364
Practice Address - Country:US
Practice Address - Phone:319-523-2001
Practice Address - Fax:319-523-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2022-11-09
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-07-29
Provider Licenses
StateLicense IDTaxonomies
IA580372314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0807271Medicaid
IA0455196Medicaid
IA0654582Medicaid
IA0654582Medicaid
165452Medicare Oscar/Certification
IA0455196Medicaid