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General NPI Number Information
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NPI Number | 1447312780
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Entity Type | Organization
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Legal Business Name | REM IOWA COMMUNITY SERVICES, INC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 06/23/2024
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Provider Practice Location Address
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Address Line | 300 W BROADWAY STE 107
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4489
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Country | US
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Telephone | 712-323-5459
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Fax | 712-323-5435
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Provider Business Mailing Address
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Address Line | 1220 INDUSTRIAL AVE STE C
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City | HIAWATHA
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State | IA
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Zip | 52233-1118
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Country | US
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Telephone | 319-393-1944
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Fax | 319-393-2091
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Authorized Official
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Title or Position | VP& SR. ASSISTANT GENERAL COUNSEL
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Name | MARY PATRICIA RODENBERG-ROBERTS
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Credential |
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Telephone | 952-836-2234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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