| Opportunity Village | |
|
1200 N 9th St W Clear Lake IA 50428-1100 | |
| (641) 357-5277 | |
| (641) 357-6491 |
| Full Name | Opportunity Village |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1200 N 9th St W, Clear Lake, Iowa |
| Authorized Official Name and Position | Gregory Braun (CFO) |
| Authorized Official Contact | 6413551200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Opportunity Village Po Box 622 Clear Lake IA 50428-0622 Ph: (641) 357-5277 | Opportunity Village 1200 N 9th St W Clear Lake IA 50428-1100 Ph: (641) 357-5277 |
| NPI Number | 1043361744 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043361744 | NPI | - | NPPES |
| 0089094 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 Fax: 641-357-6491 | |
Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 | |
Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 Fax: 641-357-6491 | |
Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 | |
Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 Fax: 641-357-6491 | |
Opportunity Village Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 N 9th St W, Clear Lake, IA 50428 Phone: 641-357-5277 |