Provider Demographics
NPI:1821710773
Name:PRIORITY CARE LLC
Entity Type:Organization
Organization Name:PRIORITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NADEENA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-312-1678
Mailing Address - Street 1:300 W BROADWAY STE 114
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9030
Mailing Address - Country:US
Mailing Address - Phone:712-713-2040
Mailing Address - Fax:
Practice Address - Street 1:300 W BROADWAY STE 114
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9030
Practice Address - Country:US
Practice Address - Phone:712-713-2040
Practice Address - Fax:712-713-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities