Organization
CENTRAL IOWA JUVENILE DETENTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY REED (EXECUTIVE DIRECTOR)
(641) 858-3852
Entity
Organization
Contact information
Practice address
2317 RICK COLLINS WAY, ELDORA, IA 50627-8356
(641) 858-3852
(641) 939-7839
Mailing address
2317 RICK COLLINS WAY, ELDORA, IA 50627-8356
(641) 858-3852
(641) 939-7839
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
X000402486
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X000402486
STATE OF IOWA REMEDIAL SERVICE PROVIDER FUNDED BY MEDICAID
IA
Enumeration date
06/02/2011
Last updated
06/02/2011
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