Provider Demographics
NPI:1891760450
Name:JASPER COUNTY HOME CARE AIDES
Entity Type:Organization
Organization Name:JASPER COUNTY HOME CARE AIDES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER JASPER CO BOARD OF H
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GWINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-787-9224
Mailing Address - Street 1:115 N 2ND AVE E
Mailing Address - Street 2:COUNTY ANNEX BUILDING
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3241
Mailing Address - Country:US
Mailing Address - Phone:641-787-9224
Mailing Address - Fax:941-791-4022
Practice Address - Street 1:115 N 2ND AVE E
Practice Address - Street 2:COUNTY ANNEX BUILDING
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3241
Practice Address - Country:US
Practice Address - Phone:641-787-9224
Practice Address - Fax:941-791-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0211672Medicaid