Healthcare Provider Details

I. General information

NPI: 1457800195
Provider Name (Legal Business Name): TRUTH FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 E MAIN ST
NEW LONDON IA
52645-1218
US

IV. Provider business mailing address

304 E MAIN ST P.O. BOX 165
NEW LONDON IA
52645-1218
US

V. Phone/Fax

Practice location:
  • Phone: 319-931-7169
  • Fax: 855-275-2734
Mailing address:
  • Phone: 319-931-7169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number083324
License Number StateIA

VIII. Authorized Official

Name: MRS. ANNIE POWELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 319-931-7169