Organization
SHADE OF THE TREE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GIGSTAD MA (OWNER)
(712) 330-9140
Entity
Organization
Contact information
Practice address
3013 ZENITH AVE UNIT B, SPIRIT LAKE, IA 51360-2134
(712) 330-9140
Mailing address
826 LAKE ST, SPIRIT LAKE, IA 51360-1650
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IA
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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