1861591901 NPI number — CENTRAL IOWA THERAPY ASSOCIATES 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 1861591901 NPI number — CENTRAL IOWA THERAPY ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL IOWA THERAPY ASSOCIATES 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:
1861591901
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6310 PRAIRIE RIDGE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-291-8889
Provider Business Mailing Address Fax Number:
515-292-7698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
906 9TH ST
Provider Second Line Business Practice Location Address:
STE. 218
Provider Business Practice Location Address City Name:
BOONE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50036-2760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-291-8889
Provider Business Practice Location Address Fax Number:
515-292-7698
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCCLAIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
P
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
515-291-8889

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  156 , 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)





Copyright © 2007-2025 www.npivalidator.com