Provider Demographics
NPI:1932279254
Name:SIOUX CENTER HEALTH
Entity Type:Organization
Organization Name:SIOUX CENTER HEALTH
Other - Org Name:SIOUX CENTER HEALTH HOME CARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-8153
Mailing Address - Street 1:1101 9TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-2501
Mailing Address - Country:US
Mailing Address - Phone:712-722-1271
Mailing Address - Fax:
Practice Address - Street 1:1400 7TH AVE SE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-1199
Practice Address - Country:US
Practice Address - Phone:712-722-8108
Practice Address - Fax:712-722-1294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIOUX CENTER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA840080H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0615195Medicaid
IA161519Medicare Oscar/Certification