Organization
XIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH R. CLAIBOURN (CEO)
(515) 993-2123
Entity
Organization
Contact information
Practice address
705 MAIN ST, ADEL, IA 50003-1523
(515) 993-2123
(515) 993-2276
Mailing address
707 MAIN STREET, ADEL, IA 50003-1523
(515) 993-2123
(515) 993-2276
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109338
—
IA
05
—
0211394
—
IA
Enumeration date
07/24/2012
Last updated
09/19/2013
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