Provider Demographics
NPI:1922290998
Name:CAREAGE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:CAREAGE MANAGEMENT, LLC
Other - Org Name:CAREAGE OF FORT DODGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-293-0117
Mailing Address - Street 1:728 14TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-7016
Mailing Address - Country:US
Mailing Address - Phone:712-293-0117
Mailing Address - Fax:712-293-0356
Practice Address - Street 1:728 14TH AVE N
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-7016
Practice Address - Country:US
Practice Address - Phone:712-293-0117
Practice Address - Fax:712-293-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165156Medicare Oscar/Certification