Healthcare Provider Details

I. General information

NPI: 1073456976
Provider Name (Legal Business Name): RACHEL R MANNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 OLIVE ST
ATLANTIC IA
50022-9768
US

IV. Provider business mailing address

309 S 7TH ST STE B
ADEL IA
50003-1838
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-5091
  • Fax:
Mailing address:
  • Phone: 712-243-5091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: