Organization
PACE IOWA
Active
Parent organization
IMMANUEL HOME AND COMMUNITY RESOURCES
Other names
Immanuel Pathways
Organization subpart
Yes
Provider details
NPI number
Legal business name
IMMANUEL HOME AND COMMUNITY RESOURCES
Authorized official
MR. ANDREW J FISHER (VP OF COMMUNITY OPERATIONS)
(402) 829-2954
Entity
Organization
Contact information
Practice address
1702 N 16TH ST, COUNCIL BLUFFS, IA 51501-0121
(712) 256-7284
Mailing address
6757 NEWPORT AVE, SUITE 200, OMAHA, NE 68152-2262
(402) 829-2900
(402) 829-2939
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
10/08/2010
Last updated
10/17/2013
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