| Youth Shelter Care Of North Central Iowa Inc | |
|
301 Avenue M W Fort Dodge IA 50501-5623 | |
| (515) 955-4834 | |
| (515) 955-6828 |
| Full Name | Youth Shelter Care Of North Central Iowa Inc |
|---|---|
| Speciality | Counselor |
| Location | 301 Avenue M W, Fort Dodge, Iowa |
| Authorized Official Name and Position | Laurence R Mcluckie (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5159554834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Shelter Care Of North Central Iowa Inc 301 Avenue M W Fort Dodge IA 50501-5623 Ph: (515) 955-4834 | Youth Shelter Care Of North Central Iowa Inc 301 Avenue M W Fort Dodge IA 50501-5623 Ph: (515) 955-4834 |
| NPI Number | 1003979139 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003979139 | NPI | - | NPPES |
| 0466243 | Medicaid | IA | |
| 1153908 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Iowa) | Primary |
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