Provider Demographics
NPI:1487080297
Name:AEGIS THERAPIES
Entity type:Organization
Organization Name:AEGIS THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COTA
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:LARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-814-2275
Mailing Address - Street 1:1433 SILVERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-3940
Mailing Address - Country:US
Mailing Address - Phone:641-814-2275
Mailing Address - Fax:
Practice Address - Street 1:819 COUNTRY LANE RD
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-1001
Practice Address - Country:US
Practice Address - Phone:319-293-3761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000953311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home