Organization
MID IOWA BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E. THACKER MA, IAADC, SAP (OWNER/EXECUTIVE DIRECTOR)
(515) 571-7953
Entity
Organization
Contact information
Practice address
1300 37TH ST STE 4, WEST DES MOINES, IA 50266-1900
(515) 571-7953
(515) 868-0306
Mailing address
1300 37TH ST STE 4, WEST DES MOINES, IA 50266-1900
(515) 571-7953
(515) 868-0306
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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