Organization
NORTHEAST IOWA MENTAL HEALTH CENTER
Active
Other names
Northeast Iowa Behavioral Health, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARCIA OLTROGGE MA (EXECUTIVE DIRECTOR)
(563) 382-3649
Entity
Organization
Contact information
Practice address
905 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-3649
(563) 382-8183
Mailing address
PO BOX 349, 905 MONTGOMERY ST., DECORAH, IA 52101-0349
(563) 382-3649
(563) 382-8183
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
NONE
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074559
—
IA
Enumeration date
05/25/2006
Last updated
04/18/2012
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