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Organization

FAMILY ADVOCACY RESOURCES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES WILKINSON (ADMINISTRATOR)
(515) 438-4214
Entity
Organization

Contact information

Practice address
124 SOUTH MAIN, WOODWARD, IA 50276
(515) 438-4214
(515) 438-4217
Mailing address
PO BOX 410, WOODWARD, IA 50276-0410
(515) 438-4214
(515) 438-4217

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00417
IA
101YM0800X
Mental Health Counselor
02516
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0266627
IA
05
0266981
IA
Enumeration date
01/03/2007
Last updated
08/22/2020
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