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6000 Grand Avenue Suite G Des Moines IA 50312 | |
| (515) 243-6929 | |
| (515) 243-1747 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6000 Grand Avenue Suite G, Des Moines, Iowa |
| Authorized Official Name and Position | Jenny Erdman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5152436929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6000 Grand Avenue Suite G Des Moines IA 50312 Ph: (515) 243-6929 | 6000 Grand Avenue Suite G Des Moines IA 50312 Ph: (515) 243-6929 |
| NPI Number | 1528153285 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 04/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528153285 | NPI | - | NPPES |
| 0235739 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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