Children's Square U.s.a. | |
North 6th & Ave E Council Bluffs IA 51502-3008 | |
(712) 322-3700 | |
(712) 323-6968 |
Full Name | Children's Square U.s.a. |
---|---|
Speciality | Community/behavioral Health |
Location | North 6th & Ave E, Council Bluffs, Iowa |
Authorized Official Name and Position | Mark J Duman (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7123223700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Children's Square U.s.a. Po Box 8c Council Bluffs IA 51502-3008 Ph: (712) 322-3700 | Children's Square U.s.a. North 6th & Ave E Council Bluffs IA 51502-3008 Ph: (712) 322-3700 |
NPI Number | 1255477675 |
---|---|
Provider Enumeration Date | 01/30/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255477675 | NPI | - | NPPES |
2104026 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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