Healthcare Provider Details

I. General information

NPI: 1174446025
Provider Name (Legal Business Name): SIOUXLAND COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 WAR EAGLE DR
SIOUX CITY IA
51109-1700
US

IV. Provider business mailing address

1021 NEBRASKA ST
SIOUX CITY IA
51105-1436
US

V. Phone/Fax

Practice location:
  • Phone: 712-224-4300
  • Fax: 712-224-4340
Mailing address:
  • Phone: 712-252-2477
  • Fax: 712-252-5920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARK DONALDSON
Title or Position: CEO
Credential:
Phone: 712-226-9010