Provider Demographics
NPI:1538494547
Name:IOWA HOME BASED SERVICES
Entity Type:Organization
Organization Name:IOWA HOME BASED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:319-524-2507
Mailing Address - Street 1:23 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-5815
Mailing Address - Country:US
Mailing Address - Phone:319-524-2507
Mailing Address - Fax:319-524-1894
Practice Address - Street 1:23 S 2ND ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-5815
Practice Address - Country:US
Practice Address - Phone:319-524-2507
Practice Address - Fax:319-524-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare