| Romans Ranch Inc. | |
|
2197 210th St Boone IA 50036-7441 | |
| (515) 298-2202 | |
| Not Available |
| Full Name | Romans Ranch Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2197 210th St, Boone, Iowa |
| Authorized Official Name and Position | Danielle Dawn Andersen-jeppesen (OWNER) |
| Authorized Official Contact | 5152982202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Romans Ranch Inc. 2197 210th St Boone IA 50036-7441 Ph: (515) 298-2202 | Romans Ranch Inc. 2197 210th St Boone IA 50036-7441 Ph: (515) 298-2202 |
| NPI Number | 1821667254 |
|---|---|
| Provider Enumeration Date | 06/21/2021 |
| Last Update Date | 07/03/2024 |
| Certification Date | 07/03/2024 |
| Medicare PECOS PAC ID | 2062956725 |
|---|---|
| Medicare Enrollment ID | O20240705000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821667254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kimberley Pontius |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265596381 PECOS PAC ID: 8022477272 Enrollment ID: I20240705001012 |
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