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General NPI Number Information
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NPI Number | 1598158156
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACCESS & LIFE MANAGEMENT, INC
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 333 SW 9TH ST SUITE J
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City | DES MOINES
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State | IA
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Zip | 50309-4440
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Country | US
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Telephone | 515-777-3075
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Fax | 515-777-1719
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Provider Business Mailing Address
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Address Line | 333 SW 9TH ST SUITE J
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City | DES MOINES
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State | IA
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Zip | 50309-4440
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Country | US
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Telephone | 515-777-3075
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Fax | 515-777-1719
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GLORIA KRAUSE
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Credential | LISW
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Telephone | 515-777-3075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 007236
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License Number State | IA
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