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General NPI Number Information
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NPI Number | 1962673624
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Entity Type | Organization
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Legal Business Name | ALZHEIMER'S ASSOCIATION BIG SIOUX CHAPTER
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 420 CHAMBERS ST
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City | SIOUX CITY
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State | IA
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Zip | 51101-2126
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Country | US
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Telephone | 712-279-5802
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Fax | 712-277-8076
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Provider Business Mailing Address
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Address Line | 420 CHAMBERS ST PO BOX 3716
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City | SIOUX CITY
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State | IA
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Zip | 51101-2126
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Country | US
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Telephone | 712-279-5802
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Fax | 712-277-8076
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Authorized Official
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Title or Position | INTERIM EXECUTIVE DIRECTOR
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Name | ERIC NEWHOUSE
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Credential |
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Telephone | 712-279-5802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADS033
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License Number State | IA
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