Organization
POWESHIEK COUNTY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYKE SELHA LISW (EXECUTIVE DIRECTOR)
(641) 236-6137
Entity
Organization
Contact information
Practice address
200 4TH AVE WEST, GRINNELL, IA 50112
(641) 236-6137
(641) 236-0206
Mailing address
200 4TH AVE WEST, GRINNELL, IA 50112
(641) 236-6137
(641) 236-0206
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069468
—
IA
01
—
06946
WELLMARK BCBS
IA
Enumeration date
09/20/2006
Last updated
02/13/2012
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