National Provider Identifier Database

GREAT RIVER CHILD CARE INC
Respite Care, Intellectual and/or Developmental Disabilities

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.


Contact Information

GREAT RIVER CHILD CARE INC.
639 S CENTRAL AVE
BURLINGTON, IA52601-3946
Phone: 319-752-0940
Fax: 319-752-0941
Website:
Specialty Taxonomy Code
* Respite Care, Intellectual and/or Developmental Disabilities 385HR2060X

* Indicates primary specialty

NPI Profile & details for GREAT RIVER CHILD CARE INC.

NPI Number 1104022953
Legal business name
LBN
GREAT RIVER CHILD CARE INC.
Authorized official NANCY TUCKER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/26/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • IA License #: 4129000011
  • IA Medicaid: 0418160

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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