Organization
CHATHAM OAKS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIVIAN ROMAINE DAVIS (EXECUTIVE DIRECTOR)
(319) 887-2701
Entity
Organization
Contact information
Practice address
4515 MELROSE AVE, IOWA CITY, IA 52246-9400
(319) 887-2701
(319) 887-9154
Mailing address
4515 MELROSE AVE, IOWA CITY, IA 52246-9400
(319) 887-2701
(319) 887-9154
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
R-457
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0894303
—
IA
Enumeration date
11/01/2006
Last updated
08/22/2020
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