Organization
COMMUNITY NEUROREHAB OF IOWA
Active
Other names
Community NeuroRehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN L POLKOW (PRESIDENT)
(415) 209-9802
Entity
Organization
Contact information
Practice address
3000 SW 37TH ST, DES MOINES, IA 50321-1330
(515) 288-8222
Mailing address
3000 SW 37TH ST, DES MOINES, IA 50321-1330
(515) 288-8222
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
771045
IA
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
771045
IA
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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