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General NPI Number Information
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NPI Number | 1417637877
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Entity Type | Organization
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Legal Business Name | CIRCLE CITY ABA OF IOWA LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 1250 SW STATE ST
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City | ANKENY
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State | IA
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Zip | 50023-2555
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Country | US
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Telephone | 319-382-9318
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Fax |
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Provider Business Mailing Address
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Address Line | 2407 SE DELAWARE AVE # 1140
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City | ANKENY
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State | IA
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Zip | 50021-4470
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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 | CFO
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Name | BRIAN BILLAND
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Credential |
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Telephone | 765-588-9165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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