Organization
PASSION HEALTH CARE PROVIDER LLC
Active
Other names
Passion Health Care Provider LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DERICK MBACHAM (EXECUTIVE DIRECTOR)
(515) 525-5369
Entity
Organization
Contact information
Practice address
208 NW DRIFTWOOD CT, ANKENY, IA 50023-6817
(515) 525-5369
Mailing address
208 NW DRIFTWOOD CT, ANKENY, IA 50023-6817
(515) 525-5369
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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