| Children's Square U.s.a. | |
|
705 Douglas St Suite 652 Sioux City IA 51101-1048 | |
| (712) 255-9061 | |
| (712) 255-3729 |
| Full Name | Children's Square U.s.a. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 705 Douglas St, Sioux City, Iowa |
| Authorized Official Name and Position | Mark J Duman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7123223700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Square U.s.a. Po Box 8c Council Bluffs IA 51502-3008 Ph: (712) 322-3700 | Children's Square U.s.a. 705 Douglas St Suite 652 Sioux City IA 51101-1048 Ph: (712) 255-9061 |
| NPI Number | 1306992805 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306992805 | NPI | - | NPPES |
| 1104026 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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