Organization
PREMIER WAIVER HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH ANDREW HUDSON (FOUNDER)
(712) 870-4793
Entity
Organization
Contact information
Practice address
701 WEST ST, SHENANDOAH, IA 51601-1936
(712) 242-5993
(515) 655-8519
Mailing address
PO BOX 364, CLARINDA, IA 51632-0364
(712) 242-5993
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
01/23/2025
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