Childserve Habilitation Center

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

770916 Issued in IA

Legal business name

CHILDSERVE HABILITATION CENTER

Practice address

5900 Pioneer Pkwy
Johnston, IA 50131-1569

Phone

(515) 270-2205

Fax

(515) 276-0140

NPI assigned

Feb 18, 2007

Organization subpart

No

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

Addresses

Other identifiers 1

Tax ID family

Childserve Habilitation Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Childserve Habilitation Center Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Johnston, IA
  • NPI 1538387857
  NPD tax ID

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962546374",
    "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": "5900 PIONEER PKWY",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311569",
            "telephone_number": "515-270-2205",
            "fax_number": "515-276-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDSERVE HABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-18",
        "last_updated": "2020-08-22",
        "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": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "IA",
            "license": "770916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0659938",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Iowa Hospital Corporation
• Central States Mobility Inc
• Daisy Alejandra Cerna Poster
• Lorraine Chidester, APRN, PMHNP
• Childserve Community Options, Inc.
• Childserve Habilitation Center Inc.
• Childserve Homecare Inc
• Childserve Homes Inc.
• Childserve Homes Inc.
• Childserve Homes Inc.

• Pediatric Skilled Nursing Facility in Johnston, IA
• Providers in Johnston, IA by specialty
• Pediatric Skilled Nursing Facility 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.