Organization
OPPORTUNITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL WESTCOTT (FINANCIAL OFFICER)
(712) 464-8961
Entity
Organization
Contact information
Practice address
1890 E MAIN ST, LAKE CITY, IA 51449-7706
(712) 464-8961
(712) 464-3320
Mailing address
1890 E MAIN ST, LAKE CITY, IA 51449-7706
(712) 464-8961
(712) 464-3320
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
IMR556
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0880476
—
IA
Enumeration date
11/29/2006
Last updated
08/22/2020
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