MEDICARE: CENTER FOR HUMAN DEVELOPMENT, 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	251S00000X	Community/Behavioral Health 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	:	1912058967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR HUMAN DEVELOPMENT, INC

Provider Business Mailing Address
First Line	:	1504 HIAWATHA TRL
Second Line	:	PO BOX 1326
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-4325
Country	:	US
Telephone Number	:	712-239-1695
Fax Number	:	712-239-1695

Provider Business Practice Location Address
First Line	:	1504 HIAWATHA TRL
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-4325
Country	:	US
Telephone Number	:	712-239-1695
Fax Number	:	712-239-1695

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. CAROL WHITEHILL
Credential	:	E.D.D
Telephone Number	:	712-239-1695

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/22/2020

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