Organization
COMMUNITY CARE OF PLEASANT HILL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE BOEHM JR. LNHA (PRESIDENT)
(712) 210-6296
Entity
Organization
Contact information
Practice address
4755 PARKRIDGE AVE, PLEASANT HILL, IA 50327-7228
(515) 777-3631
Mailing address
PO BOX 57010, DES MOINES, IA 50317-0001
(515) 777-3631
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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