| |
2301 Eastern Ave, Red Oak, IA 51566-0498 | |
(712) 623-7156 | |
(712) 623-7224 |
Full Name | |
---|---|
Type | Facility |
Speciality | Home Delivered Meals |
Location | 2301 Eastern Ave, Red Oak, Iowa |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558496620 | NPI | - | NPPES |
0164715 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 690075H (Iowa) | Primary |
332U00000X | Home Delivered Meals | 690075H (Iowa) | Primary |
Mailing Address | Practice Location Address |
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Po Box 498, Red Oak, IA 51566-0498 Ph: (712) 623-7156 | 2301 Eastern Ave, Red Oak, IA 51566-0498 Ph: (712) 623-7156 |