Basic Information
| Provider Information | |||||||||
| NPI: | 1457574543 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESTMINSTER HOUSE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 940 CUMMINS PKWY | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503121100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152358820 | ||||||||
| FaxNumber: | 5152410993 | ||||||||
| Practice Location | |||||||||
| Address1: | 5631 FRANCIS AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503101000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152358820 | ||||||||
| FaxNumber: | 5152410993 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SORENSEN | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5152358822 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 770254 | IA | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 0893727 | 05 | IA | MEDICAID | 0234609 | 05 | IA | MEDICAID |