Organization
NORTH IOWA TRANSITION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE BLEILE LISW (EXECUTIVE DIRECTOR)
(641) 424-8708
Entity
Organization
Contact information
Practice address
408 1ST ST NW, MASON CITY, IA 50401-3004
(641) 424-8708
Mailing address
PO BOX 1503, MASON CITY, IA 50402-1503
(641) 424-8708
(641) 421-7809
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
RCFPMI 501
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0892612
—
IA
Enumeration date
11/06/2006
Last updated
08/22/2020
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