Healthcare Provider Details

I. General information

NPI: 1942833298
Provider Name (Legal Business Name): UJIMA COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E. EUCLID STE 131
DES MOINES IA
50313
US

IV. Provider business mailing address

100 E EUCLID AVE STE 131
DES MOINES IA
50313-4540
US

V. Phone/Fax

Practice location:
  • Phone: 515-339-2951
  • Fax:
Mailing address:
  • Phone: 319-239-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LEAH JEAN CLARK
Title or Position: EXECUTIVE DIRECTOR
Credential: LMSW
Phone: 319-239-8831