# ALTA MODA MEDICAL SERVICES LC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alta Moda Home Healthcare LC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316368160
- **Authorized official:** MR. ABDIAZIZ N HAJIABDIRAHMAN (MANAGER)
- **Authorized official phone:** (319) 310-9128

## Contact information

- **Practice address:** 708 J AVE NE STE 200, CEDAR RAPIDS, IA 52402-4520
- **Practice address phone:** (319) 365-1440
- **Practice address fax:** (319) 365-1429
- **Mailing address:** 224 6TH AVE SW, CEDAR RAPIDS, IA 52404-2128
- **Mailing address phone:** (319) 310-9128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/20/2013
- **Last updated:** 04/08/2014