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NPI Code Detail

MEDICARE: SOUTHWEST IOWA MENTAL HEALTH CENTER

MEDICARE: SOUTHWEST IOWA MENTAL HEALTH CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D0893OTHERIABCBS OF IA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033181086
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST IOWA MENTAL HEALTH CENTER
Provider Business Mailing Address
First Line : PO BOX 34
Second Line :
City : ATLANTIC
State : IA
Zip : 50022-0034
Country : US
Telephone Number : 712-243-2606
Fax Number : 712-243-2688
Provider Business Practice Location Address
First Line : 2307 OLIVE ST
Second Line :
City : ATLANTIC
State : IA
Zip : 50022-9768
Country : US
Telephone Number : 712-243-2606
Fax Number : 712-243-2688
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. LAURIE COOLEY
Credential :
Telephone Number : 712-243-2606
Provider Enumeration Date : 02/03/2006
Last Update Date : 12/20/2022

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Directions to “SOUTHWEST IOWA MENTAL HEALTH CENTER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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