1942350798 NPI number — AMERICAN BAPTIST HOMES OF THE MIDWEST

Table of content: (NPI 1942350798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942350798 NPI number — AMERICAN BAPTIST HOMES OF THE MIDWEST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN BAPTIST HOMES OF THE MIDWEST
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942350798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 3RD AVE SW
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
CEDAR RAPIDS
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52404-5733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-364-6774
Provider Business Mailing Address Fax Number:
319-364-3925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 3RD AVE SW
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
CEDAR RAPIDS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52404-5733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-364-6774
Provider Business Practice Location Address Fax Number:
319-364-3925
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SWIGERT
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
L
Authorized Official Title or Position:
BUDGET & FINANCE COORDINATOR
Authorized Official Telephone Number:
515-331-1200

Provider Taxonomy Codes

  • Taxonomy code: 320900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0121798 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0892240 . This is a "SSA VENDOR #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com