Organization
BROADLAWNS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT J MANDRACCHIA DPM (CHIEF MEDICAL OFFICER)
(515) 282-2562
Entity
Organization
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
Mailing address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
273R00000X
Psychiatric Hospital Unit
Primary
4703006
IA
Other
Enumeration date
06/10/2008
Last updated
03/05/2013
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