Individual
LATOYA WARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1725 6TH AVE, DES MOINES, IA 50314-3304
(515) 282-8457
(515) 422-7862
Mailing address
1725 6TH AVE, DES MOINES, IA 50314-3304
(515) 282-8457
(515) 422-7862
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
770488
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47265204
TAX ID
IA
Enumeration date
03/05/2015
Last updated
03/05/2015
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