CHILDSERVE HOMES INC. (NPI# 1124162532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124162532 |
| Entity Type | Organization |
| Organization Name | CHILDSERVE HOMES INC. |
| Other Organization Name | CHILDSERVE HOMES SCL WAIVER |
| Practice Address |
5406 Merle Hay Rd Johnston IA 50131-1209 |
| Mailing Address |
Po Box 707 Johnston IA 50131-0707 |
| Practice Telephone | 5157278750 |
| Practice Fax Number | 5157278757 |
| Mailing Telephone | 5157278750 |
| Mailing Fax Number | 5157278757 |
| Enumeration Date | 2007-02-18 |
| Last Update Date | 2010-06-02 |
| Authorized Official Name | RODNEY WILDRICK (DIRECTOR OF ACCOUNTING) |
| Authorized Official Telephone | 5157271468 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDSERVE INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0122119 | 05 |
| Other Name | Type Code |
|---|---|
| ChildServe Homes SCL Waiver | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790983021 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 5555 Nw 55th Ave, Johnston, IA 50131-1367 | 2007-07-09 |
| 1710022421 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 6225 Morningside Drive, Johnston, IA 50131 | 2007-02-20 |
| 1861534695 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 2164 Sw 35th St, Ankeny, IA 50023-5901 | 2007-02-12 |
| 1245372077 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 7109 Douglas Ave, Des Moines, IA 50322-3201 | 2007-02-12 |
| 1043352875 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 7161 Wilshire Blvd, Windsor Heights, IA 50322-4823 | 2007-02-12 |
| 1952443780 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 10350 Stone Ridge St, Grimes, IA 50111-2303 | 2007-02-12 |
| 1134261969 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 10305 Stonecrest Drive, Johnston, IA 50131 | 2007-02-12 |
| 1659412617 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 2712 69th St, Urbandale, IA 50322-4917 | 2007-02-10 |
| 1487795449 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 3610 42nd St, Des Moines, IA 50310-4158 | 2007-02-10 |
| 1457492548 | Childserve Homes Inc. | Intermediate Care Facility, Mentally Retarded | 2052 Sw 35th St, #25, Ankeny, IA 50023-5900 | 2007-02-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | CHILDSERVE HOMES INC. | 5406 Merle Hay Road, Po Box 707, Johnston, IA 50131 |
| Street Address |
5406 MERLE HAY RD |
| City | JOHNSTON |
| State | IA |
| Zip Code | 50131-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346291184 | Fredrick T Klingbeil | Physical Medicine & Rehabilitation | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2006-05-15 |
| 1134735731 | Jerica Balousek | Speech-Language Pathologist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-09-18 |
| 1740896372 | Danielle Hubby | Occupational Therapist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-09-18 |
| 1891306569 | Bonnie Keller | Occupational Therapist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-08-14 |
| 1154932853 | Abbigayle Ruthann Kay | Speech-Language Pathologist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-08-14 |
| 1043829617 | Whitney Peitz | Behavioral Analyst | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-07-29 |
| 1023627643 | Taylor Dalbey | Occupational Therapist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-07-29 |
| 1265069124 | Virginia Bantz | Occupational Therapist | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-03-23 |
| 1114557733 | Shawn Kolb | Behavioral Analyst | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-01-23 |
| 1447880075 | Lindsey Williams | Behavioral Analyst | 5406 Merle Hay Rd, Johnston, IA 50131-1209 | 2020-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568011229 | Joseph Barnard | Technician | 6406 Theresa Dr, Johnston, IA 50131 | 2019-09-05 |
| 1073098208 | Heather Nicole Prettyman | Social Worker | 5406 Marle Hay Rd., Johnston, IA 50131 | 2018-10-03 |
| 1982182606 | Dental Studio of Iowa PC | Dentist | 5495 Nw 100th Street, Johnston, IA 50131 | 2018-08-03 |
| 1982063921 | Braincare, LLC | Physiological Laboratory | 6165 Nw 86th St Ste 130, Johnston, IA 50131 | 2016-02-18 |
| 1104293570 | Sarah Michelle Fees | Nurse Practitioner | 8605 Chambery Blvd, Johnston, IA 50131 | 2015-09-01 |
| 1013329978 | Jonathan Jeffrey Karch | Dentist | 5495 Nw 100th St, Johnston, IA 50131 | 2014-05-27 |
| 1053757500 | Patricia L Hart | Social Worker | 6061 Bradford Ln, Johnston, IA 50131 | 2013-05-10 |
| 1205105855 | Lesile Jane Mentele | Pharmacist | 6100 Nw 97th St, Johnston, IA 50131 | 2011-12-27 |
| 1750610812 | Amanda J Moore | Chiropractor | 8671 Northpark Ct, Johnston, IA 50131 | 2009-12-18 |
| 1225293426 | Center for Maximized Living, LLC | Chiropractor | 8671 Northpark Ct., Johnston, IA 50131 | 2008-07-28 |
| Find all providers in zip 50131 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538631817 | Black Hawk Nursing and Rehabilitation, LLC | Intermediate Care Facility, Mental Illness | 1410 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2018-12-26 |
| 1033496518 | Country View | Intermediate Care Facility, Mental Illness | 1410 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2011-11-10 |
| 1366740268 | Daves Place | Intermediate Care Facility, Mental Illness | 3140 Plank Rd, Keokuk, IA 52632-2312 | 2011-03-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.