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435 E Grand Ave Des Moines IA 50309-1919 | |
| (515) 243-3525 | |
| (515) 283-2256 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 435 E Grand Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Rod Hotek (CEO) |
| Authorized Official Contact | 6414721684 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
301 W Burlington Ave Fairfield IA 52556-3242 Ph: (641) 472-1684 | 435 E Grand Ave Des Moines IA 50309-1919 Ph: (515) 243-3525 |
| NPI Number | 1669646956 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669646956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NON CMHC (Iowa) | Primary |
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