Organization
CHILDSERVE HABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY WILDRICK (DIRECTOR OF ACCOUNTING)
(515) 727-1468
Entity
Organization
Contact information
Practice address
5900 PIONEER PKWY, JOHNSTON, IA 50131-1569
(515) 270-2205
(515) 276-0140
Mailing address
PO BOX 707, JOHNSTON, IA 50131-0707
(515) 727-8750
(515) 727-8757
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
770916
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0659938
—
IA
Enumeration date
02/18/2007
Last updated
08/22/2020
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