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Organization

MAINSTREAM LIVING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JON D ZELLWEGER (V.P. OF OPERATIONS)
(515) 232-8405
Entity
Organization

Contact information

Practice address
2012 E 13TH ST, BOX 1608, AMES, IA 50010-5601
(515) 232-8405
(515) 232-8448
Mailing address
2012 E 13TH ST, BOX 1608, AMES, IA 50010-5601
(515) 232-8405
(515) 232-8448

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0095323
IA
05
0226878
IA
05
0896613
IA
05
1226878
IA
Enumeration date
10/18/2006
Last updated
09/25/2012
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