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WILLIAM EADIE RESIDENTIAL SERVICES INC. NPI 1255477329


NPI Information

NPI: 1255477329
Provider Name: WILLIAM EADIE RESIDENTIAL SERVICES, INC.

Doing Business As: CARE

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 16D2005694

Address:
500 OPAL ST
AFTON, IA
ZIP 50830
Phone: (641) 347-5611
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WILLIAM EADIE RESIDENTIAL SERVICES, INC. is a community behavioral health in Afton, IA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. WILLIAM EADIE RESIDENTIAL SERVICES, INC. NPI is 1255477329. The provider is registered as an organization entity type.
The provider Is Doing Business As Care.

The provider's business location address is:

500 OPAL ST
AFTON, IA
ZIP 50830-078
Phone: (641) 347-5611
Fax: (641) 347-5038

The provider's authorized official is Jean M Rommes .
The authorized official title is President and has the following contact phone number 64178288495.

The CLIA number assigned to this NPI record is 16D2005694 - other - residential care facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 6/25/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthR-880682 & R-880683IOWAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10895482MEDICAIDIOWA
20233528MEDICAIDIOWA
30463406MEDICAIDIOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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