Organization
GREATLIFE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASSARA GOYOM KOMJO (OWNER)
(515) 918-3551
Entity
Organization
Contact information
Practice address
7880 HARBACH BLVD, CLIVE, IA 50325-1240
(515) 918-3551
Mailing address
10069 LINCOLN AVE, CLIVE, IA 50325-6745
(515) 918-3551
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
273Y00000X
Rehabilitation Hospital Unit
—
—
282E00000X
Long Term Care Hospital
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/30/2022
Last updated
01/07/2025
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