KEOKUK AREA GROUP HOME (NPI# 1790842615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790842615 |
| Entity Type | Organization |
| Organization Name | KEOKUK AREA GROUP HOME |
| Practice Address |
317 High St Keokuk IA 52632-5939 |
| Practice Telephone | 3195241871 |
| Practice Fax Number | 3195242612 |
| Mailing Telephone | 3195241871 |
| Mailing Fax Number | 3195242612 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS J JENKINS (QMRP ADMINISTRATOR) |
| Authorized Official Telephone | 3195241871 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
560091 | IA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0893438 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679779490 | Keokuk Area Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 317 High St, Keokuk, IA 52632-5939 | 2007-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | KEOKUK AREA GROUP HOME, INC. | 317 High St, Keokuk, IA 52632 |
| Street Address |
317 HIGH ST |
| City | KEOKUK |
| State | IA |
| Zip Code | 52632-5939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679779490 | Keokuk Area Group Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 317 High St, Keokuk, IA 52632-5939 | 2007-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265911721 | Eugenia Kay Petersen | Speech-Language Pathologist | 20 Village Circle, Keokuk Iowa, Keokuk, IA 52632 | 2018-08-07 |
| 1578984902 | Cody Kite-warth | Physical Therapy Assistant | 20 Village Circly, Keokuk, IA 52632 | 2014-01-03 |
| 1801228234 | Nicole Fett | Occupational Therapy Assistant | 20 Village Circle, Keokuk, IA 52632 | 2013-08-08 |
| 1033437140 | Teresa Dale Schenck | Nurse Practitioner | 400 N. 17th St, Teresa Schenck Dnp, Keokuk, IA 52632 | 2010-05-13 |
| 1225241052 | Kenneth Blaine Messer | Dentist | 1624 Morgan Street, Keokuk, IA 52632 | 2007-05-08 |
| 1417011024 | Donald Loren Steingreaber | Dentist | 307 N 17th, Keokuk, IA 52632 | 2006-12-20 |
| 1265501316 | John A Wilde | Dentist | 1626 Morgan St, Suite 3, Keokuk, IA 52632 | 2006-11-06 |
| 1639250293 | Charles F Eddingfield Md | General Practice | 1610 Morgan Street, Keokuk, IA 52632 | 2006-10-18 |
| 1861582835 | Nick John Daskalos | Dentist | 28 N 4th St, Keokuk, IA 52632 | 2006-10-13 |
| 1831209683 | Edward Martin Mcgreevey | Dentist | 1624 Morgan St, Keokuk, IA 52632 | 2006-08-30 |
| Find all providers in zip 52632 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033376603 | Country Living Care Center | Custodial Care Facility | 2840 K Ave, Toledo, IA 52342-9405 | 2008-05-20 |
| 1952510281 | Emeritus Properties II, Inc | Custodial Care Facility | 136 36th Avenue Sw, Cedar Rapids, IA 52404-4638 | 2007-05-22 |
| 1518086420 | Diamond Life Health Care, Inc. | Custodial Care Facility | 4912 Barnes City Rd, Montezuma, IA 50171-8544 | 2007-03-29 |
| 1750412672 | Proffitt's Residential | Custodial Care Facility | 615 West Washington St, Centerville, IA 52544-1623 | 2007-03-09 |
| 1871640144 | Legacy House LLC | Custodial Care Facility | 207 E Salem Ave, Indianola, IA 50125-2621 | 2007-01-05 |
| 1063578359 | Gbgb Lc Dba Briarwood Care Center | Custodial Care Facility | 416 S Clark St, Maquoketa, IA 52060-3226 | 2006-12-29 |
| 1285797415 | Comprehensive Systems, Inc | Custodial Care Facility | 818 N 7th St, Osage, IA 50461-1360 | 2006-12-19 |
| 1679636740 | Comprehensive Systems, Inc. | Custodial Care Facility | 841 W Main St, New Hampton, IA 50659-1005 | 2006-12-19 |
| 1780747915 | Comprehensive Systems, Inc | Custodial Care Facility | 702 Elm Street, Elma, IA 50628 | 2006-12-19 |
| 1144383464 | Comprehensive Systems, Inc | Custodial Care Facility | 695 S Illinois Ave, Mason City, IA 50401-5405 | 2006-12-18 |
| Find all providers with the same taxonomy | ||||
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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.