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General NPI Number Information
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NPI Number | 1528153285
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Entity Type | Organization
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Legal Business Name | PASSAGEWAY, INC.
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 6000 GRAND AVENUE SUITE G
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City | DES MOINES
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State | IA
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Zip | 50312
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Country | US
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Telephone | 515-243-6929
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Fax | 515-243-1747
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Provider Business Mailing Address
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Address Line | 6000 GRAND AVENUE SUITE G
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City | DES MOINES
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State | IA
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Zip | 50312
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Country | US
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Telephone | 515-243-6929
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Fax | 515-243-1747
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNY ERDMAN
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Credential | CRC
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Telephone | 515-243-6929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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