Organization
TRUST CENTER RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MPOZA RN (MANAGING DIRECTOR)
(913) 562-4326
Entity
Organization
Contact information
Practice address
8508 PRAIRIE AVE, URBANDALE, IA 50322-2302
(913) 562-4326
Mailing address
315 E 5TH ST # 202, WATERLOO, IA 50703-4757
(913) 562-4326
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
12/12/2024
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