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General NPI Number Information
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NPI Number | 1104397223
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Entity Type | Organization
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Legal Business Name | INNER HEALTH SERVICES. INC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 4685 MERLE HAY RD STE 108
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City | DES MOINES
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State | IA
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Zip | 50322-1982
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Country | US
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Telephone | 515-201-9953
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Fax | 515-251-4876
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Provider Business Mailing Address
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Address Line | 4685 MERLE HAY RD STE 108
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City | DES MOINES
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State | IA
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Zip | 50322-1982
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Country | US
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Telephone | 515-201-9953
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Fax | 515-251-4876
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA PETERSEN
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Credential | LISW
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Telephone | 515-201-9953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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