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Organization

CORRIDOR CHRISTIAN COUNSELING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ESTHER JOHNSON M S LMFT (OWNER)
(319) 321-9253
Entity
Organization

Contact information

Practice address
655 LIBERTY WAY STE 6, NORTH LIBERTY, IA 52317-9154
(319) 665-2137
Mailing address
PO BOX 667, NORTH LIBERTY, IA 52317-0667
(319) 665-2137

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
00228
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0115642
IA
Enumeration date
03/30/2011
Last updated
06/01/2011
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