Healthcare Provider Details

I. General information

NPI: 1811837032
Provider Name (Legal Business Name): DES MOINES WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 WINWOOD DR
JOHNSTON IA
50131-1821
US

IV. Provider business mailing address

5201 CONGRESS AVE STE 275
BOCA RATON FL
33487-3609
US

V. Phone/Fax

Practice location:
  • Phone: 631-672-7441
  • Fax: 323-529-8134
Mailing address:
  • Phone: 631-672-7441
  • Fax: 323-529-8134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. COLIN MCBRIDE
Title or Position: CRO
Credential:
Phone: 631-672-7441