Organization
BAKARI BEHAVIORAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WAYNE GOODSON MSW (PRESIDENT)
(319) 883-3067
Entity
Organization
Contact information
Practice address
515 BEECH ST, WATERLOO, IA 50703-3317
(319) 883-3067
(319) 883-3069
Mailing address
515 BEECH ST, WATERLOO, IA 50703-3317
(319) 883-3067
(319) 883-3069
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780977959
—
IA
05
—
370601201
—
TX
Enumeration date
05/22/2011
Last updated
08/08/2022
Update your record
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