# STORY COUNTY COMMUNITY LIFE PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366516114
- **Authorized official:** MRS. GAYLA R HARKEN (DIRECTOR)
- **Authorized official phone:** (515) 956-2600

## Contact information

- **Practice address:** 620 DULUTH ST, AMES, IA 50010-8558
- **Practice address phone:** (515) 956-2600
- **Practice address fax:** (515) 956-2609
- **Mailing address:** 104 S HAZEL AVE, AMES, IA 50010-5952
- **Mailing address phone:** (515) 956-2600
- **Mailing address fax:** (515) 956-2609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 850672 | IA | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020