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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