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Organization

GOODWILL OF THE GREAT PLAINS

Active
Other names
Wall Street Mission, Goodwill Industries
Organization subpart
No

Provider details

NPI number
Authorized official
SHAWN C FICK (VICE PRESIDENT MISSION ADVANCEMENT)
(712) 258-4511
Entity
Organization

Contact information

Practice address
3100 W 4TH ST, SIOUX CITY, IA 51103-3202
(712) 258-4511
(712) 258-7832
Mailing address
3100 W 4TH ST, SIOUX CITY, IA 51103-3202
(712) 258-4511
(712) 258-7832

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
ADS005
IA
261QA0600X
Adult Day Care Clinic/Center
261QD1600X
Developmental Disabilities Clinic/Center
261QR0400X
Rehabilitation Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082081
IA
05
0236539
IA
Enumeration date
01/08/2007
Last updated
01/31/2024
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