GOODWILL OF THE GREAT PLAINS NPI 1750439501

NPI Information

NPI: 1750439501
Provider Name: GOODWILL OF THE GREAT PLAINS

Former Legal Business Name: WALL STREET MISSION

Classification: Voluntary or Charitable - 251V00000X
Entity Type: Organization
Address:
3100 W 4TH ST
SIOUX CITY, IA
ZIP 51103
Phone: (712) 258-4511
Get Directions

GOODWILL OF THE GREAT PLAINS is a voluntary or charitable in Sioux City, IA. GOODWILL OF THE GREAT PLAINS NPI is 1750439501. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Wall Street Mission.

The provider's business location address is:

3100 W 4TH ST
SIOUX CITY, IA
ZIP 51103-202
Phone: (712) 258-4511
Fax: (712) 258-7832

The provider's authorized official is Shawn C Fick .
The authorized official title is Vice President Mission Advancement and has the following contact phone number (712) 258-4511.

The enumeration date for this NPI number is 1/8/2007 and was last updated on 1/31/2024.

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	261QA0600X	Clinic/Center	Adult Day Care			No
2	261QD1600X	Clinic/Center	Developmental Disabilities			No
3	261QR0400X	Clinic/Center	Rehabilitation			No
4	251V00000X	Voluntary or Charitable		ADS005	IOWA	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	0082081	MEDICAID	IOWA
2	0236539	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: 4/28/2024

NPI Synchronization or Removal

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