NPIMap

Organization Active NPI

Childserve Homes

  • Intellectual Disabilities Intermediate Care Facility
  • Ankeny, IA
National Provider Identifier
1609917780
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
770385 Issued in IA
Legal business name
CHILDSERVE HOMES
Practice address
1101 NW Greenwood St
Ankeny, IA 50023-1016
Phone
(515) 965-2912
Fax
(515) 965-2916
NPI assigned
Feb 9, 2007
Organization subpart
Yes
Parent organization
CHILDSERVE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
Rodney Wildrick
Title
Director of Accounting
Phone
(515) 727-1468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 770385 IA Primary

Addresses

Primary practice location

1101 NW Greenwood St
Ankeny, IA 50023-1016

Mailing address

PO Box 707
Johnston, IA 50131-0707
Phone (515) 727-8750

Other identifiers 1

IdentifierTypeStateIssuer
0881326MedicaidIA

Other names 1

  • ChildServe Ankeny Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Childserve Homes Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1609917780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501310707",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NW GREENWOOD ST",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500231016",
            "telephone_number": "515-965-2912",
            "fax_number": "515-965-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDSERVE HOMES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDSERVE INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "WILDRICK",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTING",
        "authorized_official_telephone_number": "515-727-1468"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IA",
            "license": "770385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0881326",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChildServe Ankeny Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.