Healthcare Provider Details

I. General information

NPI: 1194999094
Provider Name (Legal Business Name): IOWA SCHOOL FOR THE DEAF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 HARRY LANGDON BLVD
COUNCIL BLUFFS IA
51503-7837
US

IV. Provider business mailing address

3501 HARRY LANGDON BLVD
COUNCIL BLUFFS IA
51503-7837
US

V. Phone/Fax

Practice location:
  • Phone: 712-366-3252
  • Fax: 712-366-3225
Mailing address:
  • Phone: 712-366-3252
  • Fax: 712-366-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DIANE KNIGGE
Title or Position: STAFF NURSE
Credential: RN
Phone: 712-366-3252