Organization
SOUTHERN IOWA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA SCHARK MHA (EXECUTIVE DIRECTOR)
(641) 682-8772
Entity
Organization
Contact information
Practice address
1527 ALBIA RD, OTTUMWA, IA 52501-3907
(641) 682-8772
(641) 682-1924
Mailing address
1527 ALBIA RD, OTTUMWA, IA 52501-3907
(641) 682-8772
(641) 682-1924
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1653953670
—
IA
01
—
1659353670
BLUE CROSS & BLUE SHIELD OF IA
—
Enumeration date
11/16/2005
Last updated
12/10/2021
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