PACIFICA HEALTH SERVICES LLC
Assisted Living Facility
Des Moines, Iowa
Provider NPI: 1588697247
Organization Information:Organization Name: PACIFICA HEALTH SERVICES LLC
Practice Location:
4911 SW 19TH ST DES MOINES, IA 50315 US
Tel: 515-285-2559 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
4911 SW 19TH ST DES MOINES, IA 50315 US
Tel: 515-285-2559 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 261QP2000X | Ambulatory Health Care Facilities Clinic/Center Physical Therapy | IA | |
N | 261QH0700X | Ambulatory Health Care Facilities Clinic/Center | IA | |
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | IA | S0085 |
N | 313M00000X | Nursing & Custodial Care Facilities Nursing Facility/Intermediate Care Facility | IA | 770692 |
N | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | IA | 770692 |
Y | 261QX0100X | Ambulatory Health Care Facilities Clinic/Center | IA |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0807321 | IA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin