Organization
UPPER DES MOINES OPPORTUNITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS EDWARDS ACCOUNTANT (FISCAL DIRECTOR)
(712) 859-3885
Entity
Organization
Contact information
Practice address
101 ROBINS AVE., GRAETTINGER, IA 51342-0519
(712) 859-3885
(712) 859-3892
Mailing address
PO BOX 519, GRAETTINGER, IA 51342-0519
(712) 859-3885
(712) 859-3892
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014613
—
IA
05
—
0051730
—
IA
Enumeration date
11/28/2006
Last updated
08/22/2020
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