Provider Demographics
NPI:1649958786
Name:HOME CARE IOWA LLC
Entity type:Organization
Organization Name:HOME CARE IOWA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:GLENNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-276-0196
Mailing Address - Street 1:7012 MADISON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-2664
Mailing Address - Country:US
Mailing Address - Phone:515-276-0196
Mailing Address - Fax:
Practice Address - Street 1:7012 MADISON AVE STE C
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2664
Practice Address - Country:US
Practice Address - Phone:515-276-0196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care