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Organization

ALL THOSE YESTERDAYS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN RICHARD JENSEN (T)LMHC, IADC, CCDP (COUNSELOR)
(712) 363-5886
Entity
Organization

Contact information

Practice address
22 STONEYBROOK CIR SW, SPENCER, IA 51301-5806
(712) 363-5886
Mailing address
22 STONEYBROOK CIR SW, SPENCER, IA 51301-5806
(712) 363-5886

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
03/26/2018
Last updated
03/26/2018
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