Organization
2 LAINES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARNICE EDWARDS (ADMINISTRATOR)
(563) 676-9396
Entity
Organization
Contact information
Practice address
326 W 3RD ST UNIT 903, DAVENPORT, IA 52801-1233
(563) 676-9396
Mailing address
326 W 3RD ST UNIT 903, DAVENPORT, IA 52801-1233
(563) 676-9396
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347E00000X
Transportation Broker
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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