Organization
MOSIAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT O HOFFMAN (SVP OF FINANCE)
(402) 896-1511
Entity
Organization
Contact information
Practice address
905 HIGHWAY 69 S, FOREST CITY, IA 50436-2100
(402) 896-3884
(402) 896-1511
Mailing address
4980 S 118TH ST, OMAHA, NE 68137-2200
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
IA
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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