Healthcare Provider Details

I. General information

NPI: 1174513717
Provider Name (Legal Business Name): ORCHARD PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 8TH ST
DES MOINES IA
50309-1539
US

IV. Provider business mailing address

808 5TH AVE
DES MOINES IA
50309-1315
US

V. Phone/Fax

Practice location:
  • Phone: 515-697-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALERIE SALTSGAVER
Title or Position: CFO
Credential:
Phone: 515-246-3501