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General NPI Number Information
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NPI Number | 1083804900
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Entity Type | Organization
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Legal Business Name | NEW FOCUS, INC.
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 102 W WASHINGTON ST
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City | CENTERVILLE
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State | IA
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Zip | 52544-1550
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Country | US
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Telephone | 641-437-1722
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Fax | 641-437-1028
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Provider Business Mailing Address
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Address Line | PO BOX 364
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City | CENTERVILLE
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State | IA
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Zip | 52544-0364
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MISSY JOHNSON
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Credential |
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Telephone | 641-437-1722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 0736611
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Identifier Type | MEDICAID
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Identifier State | IA
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 0736611
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Identifier Type | MEDICAID
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Identifier State | IA
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Identifier Issuer |
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