Organization
ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVERT KUIPER (CEO)
(402) 343-4420
Entity
Organization
Contact information
Practice address
359 INDIAN HILLS DR, GLENWOOD, IA 51534-1953
(712) 527-2049
Mailing address
PO BOX 1C, COUNCIL BLUFFS, IA 51502-3001
(402) 527-2049
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
65PM28
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010090
—
IA
Enumeration date
11/14/2006
Last updated
02/10/2022
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