Healthcare Provider Details

I. General information

NPI: 1851037220
Provider Name (Legal Business Name): REMEDIAL EDUCATIONAL DEVELOPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 NE POPLAR CT
GRIMES IA
50111-2357
US

IV. Provider business mailing address

1405 NE POPLAR CT
GRIMES IA
50111-2357
US

V. Phone/Fax

Practice location:
  • Phone: 641-861-1017
  • Fax:
Mailing address:
  • Phone: 641-861-1017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL JONES JR.
Title or Position: BROAD PRESIDENT / HR MANAGER
Credential:
Phone: 641-861-1017