1326316845 NPI number — ZION INTEGRATED BEHAVIORAL HEALTH SERVICES 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 1326316845 NPI number — ZION INTEGRATED BEHAVIORAL HEALTH SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZION INTEGRATED BEHAVIORAL HEALTH SERVICES 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:
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:
1326316845
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 WALNUT ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
ATLANTIC
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50022-1571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-243-5091
Provider Business Mailing Address Fax Number:
712-243-5091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
403 E COOLBAUGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED OAK
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51566-2319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-623-4801
Provider Business Practice Location Address Fax Number:
712-623-4801
Provider Enumeration Date:
12/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
COOLEY
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
712-243-5091

Provider Taxonomy Codes

  • Taxonomy code: 261QR0405X , with the licence number:  1267 , 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: 68236 . This is a "WELLMARK - BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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