Provider Demographics
NPI:1790450393
Name:MIDWEST SENIOR CARE, LLC
Entity Type:Organization
Organization Name:MIDWEST SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-246-9280
Mailing Address - Street 1:45 WESTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-2162
Mailing Address - Country:US
Mailing Address - Phone:712-246-9280
Mailing Address - Fax:
Practice Address - Street 1:45 WESTRIDGE DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-2162
Practice Address - Country:US
Practice Address - Phone:712-246-9280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care