Organization
TEEN SUCCESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER L MOATS LBSW (ORGANIZER)
(515) 971-7605
Entity
Organization
Contact information
Practice address
408 5TH ST NW, ALTOONA, IA 50009-1427
(515) 971-7605
Mailing address
408 5TH ST NW, ALTOONA, IA 50009-1427
(515) 971-7605
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
04652
IA
Other
Enumeration date
08/01/2008
Last updated
09/15/2008
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