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General NPI Number Information
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NPI Number | 1124199872
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Entity Type | Organization
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Legal Business Name | FOCUS-FAMILY OPTIONS & COMMUNITY SUPPORTS, INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 04/12/2010
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Provider Practice Location Address
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Address Line | 501 S MAIN ST STE 2B
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-6522
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Country | US
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Telephone | 712-323-4024
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Fax | 712-323-0032
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Provider Business Mailing Address
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Address Line | 501 S MAIN ST STE 2B
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-6522
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Country | US
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Telephone | 712-323-4024
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Fax | 712-323-0032
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Authorized Official
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Title or Position | CEO-PRESIDENT
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Name | MR. DEREK LANEY
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Credential |
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Telephone | 712-323-4024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | IA
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