MEDICARE: OPPORTUNITIES UNLIMITED

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	315P00000X	Intellectual Disabilities Intermediate Care Facility	0881037	IA

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	:	1639235575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPPORTUNITIES UNLIMITED

Provider Business Mailing Address
First Line	:	3439 GLEN OAKS BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-1761
Country	:	US
Telephone Number	:	712-277-8295
Fax Number	:	712-277-8602

Provider Business Practice Location Address
First Line	:	3510 GLEN OAKS BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-1545
Country	:	US
Telephone Number	:	712-277-8295
Fax Number	:	712-277-8602

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. MICHAEL J. BRIDE
Credential	:
Telephone Number	:	712-277-8295

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	08/22/2020

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