Provider Demographics
NPI:1528204815
Name:UNITYPOINT AT HOME
Entity Type:Organization
Organization Name:UNITYPOINT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-557-3236
Mailing Address - Street 1:1776 W LAKES PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8378
Mailing Address - Country:US
Mailing Address - Phone:515-241-6161
Mailing Address - Fax:515-557-3186
Practice Address - Street 1:214 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4314
Practice Address - Country:US
Practice Address - Phone:515-574-6416
Practice Address - Fax:515-574-6985
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITYPOINT AT HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-17
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA167149Medicare Oscar/Certification