Organization
ALCOHOL & DRUG DEPENDENCY SERVICES OF SE IOWA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENA JONES (ASSOC. DIRECTOR OF ADMIN)
(319) 753-6567
Entity
Organization
Contact information
Practice address
1340 MT. PLEASANT ST, BURLINGTON, IA 52601
(317) 753-6567
(319) 753-0703
Mailing address
1340 MT. PLEASANT ST, BURLINGTON, IA 52601
(317) 753-6567
(319) 753-0703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215488
—
IA
Enumeration date
04/22/2021
Last updated
04/22/2021
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