Organization
LIGHT OF FAITH COMM. SERVICES
Active
Organization
LIGHT OF FAITH COMM. SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA LYNN FISCELLA (PROGRAM DIRECTOR)
(641) 682-0023
Entity
Organization
Contact information
Practice address
1317 N. ELM ST., OTTUWA, IA 52501
(641) 682-0023
(641) 682-1777
Mailing address
1317 N. ELM ST., OTTUWA, IA 52501
(641) 682-0023
(641) 682-1777
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
X000200331
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200331
—
IA
05
—
X00020031
—
IA
Enumeration date
01/09/2008
Last updated
07/11/2008
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