Healthcare Provider Details

I. General information

NPI: 1508883265
Provider Name (Legal Business Name): MANNING CSD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 10TH ST
MANNING IA
51455-1505
US

IV. Provider business mailing address

209 10TH ST
MANNING IA
51455-1505
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-3771
  • Fax:
Mailing address:
  • Phone: 712-655-3771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateIA

VIII. Authorized Official

Name: ROGER SCHMIEDESKAMP
Title or Position: SUPERINTENDENT
Credential:
Phone: 712-655-3771