Organization
CHILDSERVE HABILITATION CENTER INC.
Active
Parent organization
CHILDSERVE INC.
Other names
ChildServe Habilitation Center ICF/MR
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
5900 PIONEER PKWY, JOHNSTON, IA 50131-1569
(515) 270-2205
(515) 276-0140
Mailing address
PO BOX 707, JOHNSTON, IA 50131-0707
(515) 270-2205
(515) 727-8757
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
770916
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0880138
—
IA
Enumeration date
04/23/2007
Last updated
07/10/2007
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