GREATLIFE HOME CARE LLC NPI 1760192702

NPI Information

  • NPI: 1760192702
  • Provider Name: GREATLIFE HOME CARE, LLC
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 7880 HARBACH BLVD
    CLIVE, IA
    ZIP 50325
  • Phone: (515) 918-3551

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NPI Details

GREATLIFE HOME CARE, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Clive, IA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. GREATLIFE HOME CARE, LLC NPI is 1760192702. The provider is registered as an organization entity type.

The provider's business location address is:

7880 HARBACH BLVD
CLIVE, IA
ZIP 50325-240
Phone: (515) 918-3551

The provider's authorized official is Massara Goyom Komjo .
The authorized official title is Owner and has the following contact phone number (515) 918-3551.

The enumeration date for this NPI number is 11/30/2022 and was last updated on 1/7/2025.

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
1174200000XMealsNo
2251E00000XHome HealthNo
3273Y00000XRehabilitation UnitNo
4282E00000XLong Term Care HospitalNo
5320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes
6347C00000XPrivate VehicleNo

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: 11/21/2025

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