| Children Of Promise Mentoring Program | |
|
1030 5th Ave Se Ste 1200 Cedar Rapids IA 52403-2428 | |
| (319) 529-1543 | |
| Not Available |
| Full Name | Children Of Promise Mentoring Program |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1030 5th Ave Se Ste 1200, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Daniel Pledgejohnson (BEHAVIOR HEALTH COUNSELOR) |
| Authorized Official Contact | 3195291543 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children Of Promise Mentoring Program 1143 Longfellow Ave Waterloo IA 50703-1720 Ph: (319) 529-1543 | Children Of Promise Mentoring Program 1030 5th Ave Se Ste 1200 Cedar Rapids IA 52403-2428 Ph: (319) 529-1543 |
| NPI Number | 1265130587 |
|---|---|
| Provider Enumeration Date | 02/16/2023 |
| Last Update Date | 02/16/2023 |
| Certification Date | 12/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265130587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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