Healthcare Provider Details

I. General information

NPI: 1790480911
Provider Name (Legal Business Name): ZION INTEGRATED BEHAVIORAL HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 CEDAR AVE
WOODWARD IA
50276-1010
US

IV. Provider business mailing address

PO BOX 34
ATLANTIC IA
50022-0034
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-2606
  • Fax:
Mailing address:
  • Phone: 712-243-2606
  • Fax: 712-243-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURIE COOLEY
Title or Position: DIRECTOR
Credential:
Phone: 712-243-5091