MEDICARE: SACRED CENTER LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750248811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED CENTER LLC

Provider Business Mailing Address
First Line	:	1710 LINCOLN AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-1154
Country	:	US
Telephone Number	:	712-330-8090
Fax Number	:	712-330-8090

Provider Business Practice Location Address
First Line	:	1710 LINCOLN AVE
Second Line	:
City	:	SPIRIT LAKE
State	:	IA
Zip	:	51360-1154
Country	:	US
Telephone Number	:	712-330-8090
Fax Number	:	712-330-8090

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	RUTH MCCLEERY
Credential	:	LMHC
Telephone Number	:	712-330-8090

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	03/10/2026

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Directions to “SACRED CENTER LLC ” Practice Location

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