MEDICARE: SIOUXLAND AGING SERVICES INC.

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
1	251B00000X	Case Management Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1124237938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIOUXLAND AGING SERVICES INC.

Provider Business Mailing Address
First Line	:	2301 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3850
Country	:	US
Telephone Number	:	712-279-6900
Fax Number	:	712-233-3415

Provider Business Practice Location Address
First Line	:	2301 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3850
Country	:	US
Telephone Number	:	712-279-6900
Fax Number	:	712-233-3415

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANN M DEBOOM
Credential	:
Telephone Number	:	712-279-6900

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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