Provider Demographics
NPI:1750661179
Name:CDAC SERVICES OF IOWA, LLC
Entity Type:Organization
Organization Name:CDAC SERVICES OF IOWA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:JUDISCH
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:515-953-2755
Mailing Address - Street 1:14586 SCOTCH RIDGE RD
Mailing Address - Street 2:P.O. BOX 426
Mailing Address - City:CARLISLE
Mailing Address - State:IA
Mailing Address - Zip Code:50047-3131
Mailing Address - Country:US
Mailing Address - Phone:515-953-2755
Mailing Address - Fax:
Practice Address - Street 1:14586 SCOTCH RIDGE RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:IA
Practice Address - Zip Code:50047-3131
Practice Address - Country:US
Practice Address - Phone:515-953-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care