Organization Active NPI

Manawa Healthcare, LLC

  • Psychiatric Hospital
  • Council Bluffs, IA
National Provider Identifier
1174472138
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
MANAWA HEALTHCARE, LLC
Practice address
3620 S 24TH St
Council Bluffs, IA 51501-6920
Phone
(615) 861-6000
NPI assigned
Jan 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Authorized official

Name
Brian Farley
Title
VP & Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

3620 S 24TH St
Council Bluffs, IA 51501-6920

Mailing address

4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000

Other names 1

  • Methodist Jennie Edmundson Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260514001163 IA Part B Supplier - Clinic/Group Practice 8921576513 Receives reassigned benefits from 1 practitioner
Practice locations: Council Bluffs, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2340862Methodist Jennie Edmundson Behavioral Health3620 South 24TH St, Council Bluffs, IA 51501Certificate of waiverMar 23, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3620 S 24th St
Council Bluffs, IA 51501

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1174472138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 S 24TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016920",
            "telephone_number": "615-861-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANAWA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VP & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Jennie Edmundson Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.