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Organization
YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC
Active
Organization
YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAURENCE R MCLUCKIE LMSW, MBA (EXECUTIVE DIRECTOR)
(515) 955-4834
Entity
Organization
Contact information
Practice address
301 AVENUE M W, FORT DODGE, IA 50501-5623
(515) 955-4834
(515) 955-6828
Mailing address
301 AVENUE M W, FORT DODGE, IA 50501-5623
(515) 955-4834
(515) 955-6828
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466243
—
IA
05
—
1153908
—
IA
Enumeration date
12/19/2006
Last updated
08/22/2020
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