Provider Demographics
NPI:1669208567
Name:ONCARE HOSPICE IA LLC
Entity type:Organization
Organization Name:ONCARE HOSPICE IA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QUALITY AND COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:402-403-4330
Mailing Address - Street 1:16934 FRANCES ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2397
Mailing Address - Country:US
Mailing Address - Phone:402-403-4330
Mailing Address - Fax:402-403-5854
Practice Address - Street 1:4802 COUNCIL POINTE RD STE 400
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-8632
Practice Address - Country:US
Practice Address - Phone:402-403-4330
Practice Address - Fax:402-403-5854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based