Organization
GRAPEVINE CLINICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY TILLGREN (PARTNER)
(515) 369-0034
Entity
Organization
Contact information
Practice address
4949 PLEASANT ST STE 104, WEST DES MOINES, IA 50266-5494
(515) 369-0034
(844) 381-0919
Mailing address
4949 PLEASANT ST STE 104, WEST DES MOINES, IA 50266-5494
(515) 369-0034
(844) 381-0919
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007572
IA
1041C0700X
Clinical Social Worker
05815
IA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/11/2017
Last updated
02/13/2026
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