NPI 1164631214

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Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Corydon, IA

Practice location

Address: 401 S Washington St, Corydon, IA 50060-1745
Phone: (641) 872-1524
Fax: (641) 872-2843

Authorised official

Name: Mendy Middlebrook
Title: Temporary Administrator
Phone: (641) 872-1524

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence RMR-413 (IA)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Iowa →

Registry record

NPI: 1164631214
Entity type: Organization
NPI issued: 22 May 2007
Record last updated: 1 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.