=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710138334
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATHOLIC CHARITIES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2008
-----------------------------------------------------
Last Update Date | 10/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 GRAND AVE
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50309-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-244-3761
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 GRAND AVE
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50309-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-244-3761
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. NANCY K GALEAZZI
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 515-244-3761
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 00516
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------