Organization
ACTIVELY SUPPORTING INDIVIDUALS WITH CHALLENGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERIK L SHIELDS (OWNER)
(402) 917-5163
Entity
Organization
Contact information
Practice address
301 SCOTT ST, GRISWOLD, IA 51535-2044
(402) 917-5163
Mailing address
301 SCOTT ST, GRISWOLD, IA 51535-2044
(402) 917-5163
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
IA
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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