| Lisa Crouse Llc | |
|
170 W Graham Ave Council Bluffs IA 51503-6832 | |
| (531) 389-9440 | |
| Not Available |
| Full Name | Lisa Crouse Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 170 W Graham Ave, Council Bluffs, Iowa |
| Authorized Official Name and Position | Lisa K Crouse (OWNER) |
| Authorized Official Contact | 5313899440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Crouse Llc 170 W Graham Ave Council Bluffs IA 51503-6832 Ph: (531) 389-9440 | Lisa Crouse Llc 170 W Graham Ave Council Bluffs IA 51503-6832 Ph: (531) 389-9440 |
| NPI Number | 1730954611 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730954611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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