1992906366 NPI number — FAITH IN ACTION VOLUNTEERS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992906366 NPI number — FAITH IN ACTION VOLUNTEERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAITH IN ACTION VOLUNTEERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992906366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 604
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIDNEY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51652-0604
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-374-2093
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1003 INDIANA ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIDNEY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-374-2093
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YAHNKE
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
KAY
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
712-374-2093

Provider Taxonomy Codes

  • Taxonomy code: 344600000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0738799 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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