Organization
BERSOL OPEN HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTIN NDUWAYEZU (OWNER)
(319) 693-3621
Entity
Organization
Contact information
Practice address
416 DRAKE ST SW, CEDAR RAPIDS, IA 52404-8216
(319) 693-3621
Mailing address
416 DRAKE ST SW, CEDAR RAPIDS, IA 52404-8216
(319) 693-3621
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN
NONE
IA
Enumeration date
03/18/2020
Last updated
03/20/2020
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