| St. Gregory Retreat Centers, Llc | |
|
5875 Fleur Dr Des Moines IA 50321-2883 | |
| (515) 421-4066 | |
| (515) 864-0285 |
| Full Name | St. Gregory Retreat Centers, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 5875 Fleur Dr, Des Moines, Iowa |
| Authorized Official Name and Position | Timothy F Carson (CFO) |
| Authorized Official Contact | 5152987209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Gregory Retreat Centers, Llc 5875 Fleur Dr Des Moines IA 50321-2883 Ph: (515) 421-4066 | St. Gregory Retreat Centers, Llc 5875 Fleur Dr Des Moines IA 50321-2883 Ph: (515) 421-4066 |
| NPI Number | 1326445511 |
|---|---|
| Provider Enumeration Date | 12/03/2014 |
| Last Update Date | 02/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326445511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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