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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