Provider Demographics
NPI:1629252218
Name:ALL AGES CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ALL AGES CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROMOKE
Authorized Official - Middle Name:MISI
Authorized Official - Last Name:OLUTUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:319-558-6451
Mailing Address - Street 1:3330 SOUTHGATE CT SW STE 205
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5416
Mailing Address - Country:US
Mailing Address - Phone:319-558-6451
Mailing Address - Fax:319-892-0265
Practice Address - Street 1:3330 SOUTHGATE CT SW STE 205
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5416
Practice Address - Country:US
Practice Address - Phone:319-558-6451
Practice Address - Fax:319-892-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health