Community Care of Pleasant Hill LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

COMMUNITY CARE OF PLEASANT HILL LLC

Practice address

4755 Parkridge Ave
Pleasant Hill, IA 50327-7228

Phone

(515) 777-3631

NPI assigned

May 12, 2023

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bruce Boehm Jr., LNHANPI 1437719937

Title

President

Phone

(712) 210-6296

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce William Boehm Jr.

  • Mental Illness Community Based Residential Treatment Facility
  • Knoxville, IA
  • NPI 1437719937

  Community Based Residential Treatment Facility, Mental Illness

  NPD Authorized official

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1720778756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57010",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503170001",
            "telephone_number": "515-777-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 PARKRIDGE AVE",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503277228",
            "telephone_number": "515-777-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE OF PLEASANT HILL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-210-6296",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cio,LLC
• City of Pleasant Hill
• Cheryl Linn Clarke, R.PH.
• Megan Cole
• Community Care of Iowa, LLC (Not applicable)
• Corey Christopher Conrad, DDS MS
• Courtyard Estates at Cedar Pointe
• Stacy Lynn Davis, PA
• Jason Keith Detrick, PHARMD
• Debbie Ann Dettmer, LPN

• Mental Illness Community Based Residential Treatment Facility in Pleasant Hill, IA
• Providers in Pleasant Hill, IA by specialty
• Mental Illness Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.