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1111 9th St Suite 320 Des Moines IA 50314 | |
| (515) 288-1516 | |
| (515) 288-0437 |
| Full Name | |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 1111 9th St, Des Moines, Iowa |
| Authorized Official Name and Position | Tray Wade (PRESIDENT AND CEO) |
| Authorized Official Contact | 5152743400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3000 Easton Blvd Des Moines IA 50317-3124 Ph: (515) 333-4261 | 1111 9th St Suite 320 Des Moines IA 50314 Ph: (515) 288-1516 |
| NPI Number | 1679606990 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 01/10/2023 |
| Certification Date | 01/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679606990 | NPI | - | NPPES |
| 0123364 | Medicaid | IA |
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