Great River Child Care Inc.

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

License

4129000011 Issued in IA

Legal business name

GREAT RIVER CHILD CARE INC.

Practice address

639 S Central Ave
Burlington, IA 52601-3946

Phone

(319) 752-0940

Fax

(319) 752-0941

NPI assigned

Jun 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nancy K Tucker

Title

Owner

Phone

(319) 752-0940

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104022953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 S CENTRAL AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526013946",
            "telephone_number": "319-752-0940",
            "fax_number": "319-752-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 S CENTRAL AVE",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526013946",
            "telephone_number": "319-752-0940",
            "fax_number": "319-752-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER CHILD CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-752-0940"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "IA",
            "license": "4129000011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418160",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Anne Granera
• Logan Jose Granera
• Matthew Granquist, PT, DPT
• Great River Aea 16
• Great River Aea 16
• Great River Eye Care, Inc.
• Brandie Grinstead, LISW
• Grinstead, Pierce & Associates, LLC
• Amy Rebecca Groeltz, DDS
• Jennifer Hamilton, RN

• All providers in Burlington, IA
• Child Intellectual and/or Developmental Disabilities Respite Care in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.