Provider Demographics
NPI:1255153367
Name:HEALTH ASSURED HOME CARE, LLC
Entity type:Organization
Organization Name:HEALTH ASSURED HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANO
Authorized Official - Middle Name:
Authorized Official - Last Name:GAKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:CAREGIVER
Authorized Official - Phone:319-231-2856
Mailing Address - Street 1:3417 QUIGBY RD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-9132
Mailing Address - Country:US
Mailing Address - Phone:319-231-2856
Mailing Address - Fax:
Practice Address - Street 1:3417 QUIGBY RD
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-9132
Practice Address - Country:US
Practice Address - Phone:319-231-2856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAX000748426Medicaid