Organization
NOVEL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN TRACIS (EXECUTIVE)
(712) 713-8870
Entity
Organization
Contact information
Practice address
501 N 39TH ST, COUNCIL BLUFFS, IA 51501-1716
(712) 713-8870
Mailing address
501 N 39TH ST, COUNCIL BLUFFS, IA 51501-1716
(712) 713-8870
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
05/17/2023
Last updated
12/31/2023
Update your record
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