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Organization

CHILDSERVE HOMES INC.

Active
Other names
ChildServe Keystone Home
Organization subpart
No

Provider details

NPI number
Authorized official
RODNEY WILDRICK (DIRECTOR OF ACCOUNTING)
(515) 727-1468
Entity
Organization

Contact information

Practice address
10350 STONE RIDGE ST, GRIMES, IA 50111-2303
(515) 986-0554
(515) 986-0578
Mailing address
PO BOX 707, JOHNSTON, IA 50131-0707
(515) 727-8750
(515) 727-8757

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
771149
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0882118
IA
Enumeration date
02/12/2007
Last updated
07/23/2007
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