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1800 Grand Ave Des Moines IA 50309-3310 | |
| (515) 242-8488 | |
| (515) 242-8489 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1800 Grand Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Kelly Huntsman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5152481441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 University Ave Suite 200 Des Moines IA 50314-2355 Ph: (515) 248-1447 | 1800 Grand Ave Des Moines IA 50309-3310 Ph: (515) 242-8488 |
| NPI Number | 1083086359 |
|---|---|
| Provider Enumeration Date | 10/27/2015 |
| Last Update Date | 09/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083086359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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