Organization
VILLAGE NORTHWEST UNLIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY WHITSELL (CHIEF EXECUTIVE OFFICER)
(712) 324-4873
Entity
Organization
Contact information
Practice address
330 VILLAGE CIR, SHELDON, IA 51201-1243
(712) 324-4873
(712) 324-4877
Mailing address
330 VILLAGE CIR, SHELDON, IA 51201-1243
(712) 324-4873
(712) 324-4877
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
0094615
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094615
HCBS
IA
Enumeration date
11/27/2006
Last updated
08/22/2020
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