Healthcare Provider Details

I. General information

NPI: 1952320087
Provider Name (Legal Business Name): VOCATIONAL DEVELOPMENT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 S MAIN
COUNCIL BLUFFS IA
51503
US

IV. Provider business mailing address

612 S MAIN
COUNCIL BLUFFS IA
51503
US

V. Phone/Fax

Practice location:
  • Phone: 712-328-2638
  • Fax: 712-328-8161
Mailing address:
  • Phone: 712-328-2638
  • Fax: 712-328-8161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE HODAPP
Title or Position: CEO
Credential:
Phone: 712-328-2638