Healthcare Provider Details

I. General information

NPI: 1992906366
Provider Name (Legal Business Name): FAITH IN ACTION VOLUNTEERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 INDIANA ST.
SIDNEY IA
51652
US

IV. Provider business mailing address

PO BOX 604
SIDNEY IA
51652-0604
US

V. Phone/Fax

Practice location:
  • Phone: 712-374-2093
  • Fax:
Mailing address:
  • Phone: 712-374-2093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateIA

VIII. Authorized Official

Name: MS. SHARON KAY YAHNKE
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 712-374-2093