Provider Demographics
NPI:1902814536
Name:CAREGIVERS IOWA, INC.
Entity Type:Organization
Organization Name:CAREGIVERS IOWA, INC.
Other - Org Name:PROFESSIONAL HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-363-3318
Mailing Address - Street 1:139 40TH ST NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5613
Mailing Address - Country:US
Mailing Address - Phone:319-363-3318
Mailing Address - Fax:
Practice Address - Street 1:139 40TH ST NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5613
Practice Address - Country:US
Practice Address - Phone:319-363-3318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0672253Medicaid
IA67225OtherBCBS
IA0672253Medicaid