Provider Demographics
NPI:1467422907
Name:CARE INITIATIVES
Entity Type:Organization
Organization Name:CARE INITIATIVES
Other - Org Name:KINGSLEY SPECIALTY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP/CFO
Authorized Official - Prefix:MR
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 WEST LAKES PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-224-4442
Mailing Address - Fax:
Practice Address - Street 1:305 W 3RD ST
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:IA
Practice Address - Zip Code:51028-5064
Practice Address - Country:US
Practice Address - Phone:515-224-4442
Practice Address - Fax:712-378-3522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
IA750184314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0653295Medicaid
IA0808048Medicaid
IA0808048Medicaid
IA0808048Medicaid
IA0743850018Medicare NSC