Provider Demographics
NPI:1376208520
Name:FIRST VISION HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:FIRST VISION HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HERMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-980-5031
Mailing Address - Street 1:1932 SW 3RD ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2400
Mailing Address - Country:US
Mailing Address - Phone:515-528-2466
Mailing Address - Fax:515-528-2467
Practice Address - Street 1:1932 SW 3RD ST STE 4
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2400
Practice Address - Country:US
Practice Address - Phone:515-528-2466
Practice Address - Fax:515-528-2467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000240027Medicaid
IACXJK7GX9BMedicaid