Organization
WOODWARD YOUTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN HOLLENKAMP (EXECUTIVE DIRECTOR)
(515) 274-9607
Entity
Organization
Contact information
Practice address
611 5TH AVE, GROUND LEVEL, DES MOINES, IA 50309-1603
(515) 274-9607
(515) 274-9614
Mailing address
611 5TH AVE, GROUND LEVEL, DES MOINES, IA 50309-1603
(515) 274-9607
(515) 274-9614
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
317887
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1140012
—
IA
Enumeration date
06/24/2014
Last updated
06/24/2014
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