Organization
ST. GREGORY RETREAT CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY F CARSON (CFO)
(515) 298-7209
Entity
Organization
Contact information
Practice address
5875 FLEUR DR, DES MOINES, IA 50321-2883
(515) 421-4066
(515) 864-0285
Mailing address
5875 FLEUR DR, DES MOINES, IA 50321-2883
(515) 421-4066
(515) 864-0285
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/03/2014
Last updated
02/03/2015
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