UPPER DES MOINES OPPORTUNITY INC NPI 1538235528

NPI Information

NPI: 1538235528
Provider Name: UPPER DES MOINES OPPORTUNITY, INC
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization

CLIA Number: 16D2124700

Address:
101 ROBINS AVE.
GRAETTINGER, IA
ZIP 51342
Phone: (712) 859-3885
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UPPER DES MOINES OPPORTUNITY, INC is a public health or welfare in Graettinger, IA. UPPER DES MOINES OPPORTUNITY, INC NPI is 1538235528. The provider is registered as an organization entity type.

The provider's business location address is:

101 ROBINS AVE.
GRAETTINGER, IA
ZIP 51342-519
Phone: (712) 859-3885
Fax: (712) 859-3892

The provider's authorized official is Travis Edwards .
The authorized official title is Fiscal Director and has the following contact phone number (712) 859-3885.

The CLIA number assigned to this NPI record is 16D2124700 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251K00000X	Public Health or Welfare				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0014613	MEDICAID	IOWA
2	0051730	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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