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NPI Code Detail

MEDICARE: NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC

MEDICARE: NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255801536
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC
Provider Business Mailing Address
First Line : 720 KENYON RD
Second Line :
City : FORT DODGE
State : IA
Zip : 50501-5759
Country : US
Telephone Number : 800-482-8305
Fax Number :
Provider Business Practice Location Address
First Line : 135 WARNER ST
Second Line :
City : ROCKWELL CITY
State : IA
Zip : 50579-1722
Country : US
Telephone Number : 800-482-8305
Fax Number : 515-573-7898
Authorized Official
Title or Position : BUSINESS SERVICES MGR
Name : DIANE OCONNOR
Credential :
Telephone Number : 800-482-8305
Provider Enumeration Date : 11/29/2018
Last Update Date : 11/29/2018

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Directions to “NORTH CENTRAL IOWA MENTAL HEALTH CENTER INC ” Practice Location

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