Organization
CHRISTIAN HOME ASSOCIATION-CHILDREN'S SQUARE U.S.A
Active
Other names
CHILDREN'S SQUARE U.S.A.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK J DUMAN (CHIEF FINANCIAL OFFICER)
(712) 322-3700
Entity
Organization
Contact information
Practice address
705 DOUGLAS ST, SUITE 652, SIOUX CITY, IA 51101-1048
(712) 255-9061
(712) 255-3729
Mailing address
PO BOX 8C, COUNCIL BLUFFS, IA 51502-3008
(712) 322-3700
(712) 323-6968
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104026
—
IA
Enumeration date
01/26/2007
Last updated
08/22/2020
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