| Catholic Charities | |
|
300 W Broadway Suite 223 Council Bluffs IA 51503-9045 | |
| (712) 328-3086 | |
| (712) 328-1348 |
| Full Name | Catholic Charities |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 300 W Broadway, Council Bluffs, Iowa |
| Authorized Official Name and Position | Nancy Galeazzi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5152375053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Charities 300 W Broadway Suite 223 Council Bluffs IA 51503-9045 Ph: (712) 328-3086 | Catholic Charities 300 W Broadway Suite 223 Council Bluffs IA 51503-9045 Ph: (712) 328-3086 |
| NPI Number | 1215153895 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 05/22/2012 |
| Medicare PECOS PAC ID | 5294998712 |
|---|---|
| Medicare Enrollment ID | O20120521000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215153895 | NPI | - | NPPES |
| 787969000 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Sharon R Bandstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366473217 PECOS PAC ID: 3971523689 Enrollment ID: I20051123000676 |
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