Organization
CHILDSERVE HOMES INC.
Active
Parent organization
CHILDSERVE INC.
Other names
ChildServe Homes SCL Waiver
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDSERVE INC.
Authorized official
RODNEY WILDRICK (DIRECTOR OF ACCOUNTING)
(515) 727-1468
Entity
Organization
Contact information
Practice address
5406 MERLE HAY RD, JOHNSTON, IA 50131-1209
(515) 727-8750
(515) 727-8757
Mailing address
PO BOX 707, JOHNSTON, IA 50131-0707
(515) 727-8750
(515) 727-8757
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122119
—
IA
Enumeration date
02/18/2007
Last updated
06/02/2010
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