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General NPI Number Information
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NPI Number | 1285275875
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Entity Type | Organization
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Legal Business Name | NEW JOURNEY ADDICTION COUNSELING, LLC.
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 208 5TH ST STE 150
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City | AMES
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State | IA
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Zip | 50010-6259
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Country | US
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Telephone | 515-232-1799
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Fax | 515-232-5635
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Provider Business Mailing Address
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Address Line | 208 5TH ST STE 150
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City | AMES
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State | IA
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Zip | 50010-6259
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Country | US
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Telephone | 515-232-1799
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Fax | 515-232-5635
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Authorized Official
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Title or Position | ADDICTION COUNSELOR
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Name | CHERI L L DEGROOT
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Credential | IADC
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Telephone | 515-509-0272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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