| Parent Enrichment Program | |
|
9339 Lakewood Circle Norwalk IA 50211-1867 | |
| (515) 250-9759 | |
| (515) 285-4876 |
| Full Name | Parent Enrichment Program |
|---|---|
| Speciality | Social Worker |
| Location | 9339 Lakewood Circle, Norwalk, Iowa |
| Authorized Official Name and Position | Catherine Ann Vickroy (PRESIDENT LISW) |
| Authorized Official Contact | 5152509759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parent Enrichment Program 9339 Lakewood Circle Norwalk IA 50211-1867 Ph: (515) 250-9759 | Parent Enrichment Program 9339 Lakewood Circle Norwalk IA 50211-1867 Ph: (515) 250-9759 |
| NPI Number | 1114141579 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 07/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114141579 | NPI | - | NPPES |
| 0472548 | Other | IA | MEDICAID MENTAL HEALTH WAIVER |
| 0472548 | Medicaid | IA | |
| 0733923 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | LISW01215 (Iowa) | Primary |
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