Organization
CENTER VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARLA N WINSLOW (EXECUTIVE DIRECTOR)
(319) 293-3107
Entity
Organization
Contact information
Practice address
19248 MAPLE AVE, KEOSAUQUA, IA 52565-8288
(319) 293-3107
(319) 293-3885
Mailing address
19248 MAPLE AVE, KEOSAUQUA, IA 52565-8288
(319) 293-3107
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
0895839
IA
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
890403
IA
Other
Enumeration date
02/28/2007
Last updated
07/16/2007
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