Organization
CARE INITIATIVES
Active
Other names
Southridge Specialty Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DIXON (SVP/CFO)
(515) 224-4442
Entity
Organization
Contact information
Practice address
309 W MERLE HIBBS BLVD, MARSHALLTOWN, IA 50158-4694
(641) 752-4553
(641) 752-7776
Mailing address
1611 W LAKES PKWY, WEST DES MOINES, IA 50266-8212
(515) 224-4442
(515) 224-0960
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
640136
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0652099
—
IA
05
—
0808204
—
IA
Enumeration date
02/03/2006
Last updated
11/10/2022
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