Organization
HANDICAP VILLAGE
Active
Other names
Opportunity Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J BRAUN (CFO)
(641) 355-1200
Entity
Organization
Contact information
Practice address
1200 N 9TH ST W, CLEAR LAKE, IA 50428-1100
(641) 357-5277
(641) 357-6491
Mailing address
PO BOX 622, CLEAR LAKE, IA 50428-0622
(641) 357-5277
(641) 357-6491
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0746982
—
IA
Enumeration date
04/04/2007
Last updated
08/22/2020
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