Organization
MENTAL HEALTH INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHASKER DAVE M.D. (SUPERINTENDANT)
(319) 334-2583
Entity
Organization
Contact information
Practice address
2277 IOWA AVE, INDEPENDENCE, IA 50644-9106
(319) 334-2583
(319) 334-5252
Mailing address
2277 IOWA AVE, INDEPENDENCE, IA 50644-9106
(319) 334-2583
(319) 334-5252
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
100068H
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0640037
—
IA
01
—
64003
BL. CR. BL. SH. PROV. NO.
IA
Enumeration date
01/13/2006
Last updated
08/05/2010
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