NORTH IOWA JUVENILE DETENTION SERVICES (NPI# 1174976757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174976757 |
| Entity Type | Organization |
| Organization Name | NORTH IOWA JUVENILE DETENTION SERVICES |
| Practice Address |
1440 W Dunkerton Rd Waterloo IA 50703-9648 |
| Practice Telephone | 3192912455 |
| Practice Fax Number | 3192912464 |
| Mailing Telephone | 3192912455 |
| Mailing Fax Number | 3192912464 |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |
| Authorized Official Name | AMBER LACINA (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3192912455 |
| Authorized Official Credential | BSN, RN, MSN, AP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
1440 W DUNKERTON RD |
| City | WATERLOO |
| State | IA |
| Zip Code | 50703-9648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306470851 | Michelle A Richmond | Nurse Practitioner | 1440 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2020-02-24 |
| 1730729922 | Sara Geiger | Social Worker | 1440 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2020-01-15 |
| 1376182436 | Carol Witmer | Social Worker | 1440 W Dunkerton Rd, Waterloo, IA 50703-9648 | 2020-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306363841 | Kristie Wood | Counselor | 1420 W. Donald St, Waterloo, IA 50703 | 2017-08-25 |
| 1215359054 | Chuck Corwin | Counselor | 607 Sycamore Street, Suite 300, Waterloo, IA 50703 | 2014-01-14 |
| 1679672554 | Linda D Bartollas | Social Worker | 146 West Dale Street, Suite 101, Waterloo, IA 50703 | 2006-09-21 |
| 1558477745 | Brent Matthew Hintz | Obstetrics & Gynecology | 212 West Dale St., Suite 402, Waterloo, IA 50703 | 2006-08-21 |
| 1588629729 | Mir Ahmad Waziri | Pediatrics | 212 W Dale Street, Suite 302, Waterloo, IA 50703 | 2006-04-19 |
| 1568432615 | Wei Yang | Pathology | Northeast Iowa Pathology Associates, PC, 1825 Logan Avenue, Waterloo, IA 50703 | 2006-01-23 |
| 1689158040 | Megan Elizabeth O'neal | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2018-09-21 |
| 1972031359 | Stephanie Rose Smith | Nurse Practitioner | 1631 Logan Ave, Waterloo, IA 50703 | 2017-05-30 |
| 1801263462 | Krissy Jean Wieland | Nurse Practitioner | 220 Franklin St, Waterloo, IA 50703 | 2015-08-28 |
| 1699169698 | Jens Masters Olsen | Emergency Medicine | 1825 Logan Ave, Waterloo, IA 50703 | 2015-03-27 |
| Find all providers in zip 50703 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134264807 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 1210 Idaho St, Waterloo, IA 50703-4328 | 2007-02-21 |
| 1275609299 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2006-11-28 |
| 1023134905 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2007-03-22 |
| 1932225745 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2007-03-22 |
| 1003975160 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2006-12-06 |
| 1912066077 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2006-12-06 |
| 1619036787 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2006-12-06 |
| 1841367653 | Exceptional Persons, Inc | Community Based Residential Treatment Facility, Mental Illness | 760 Ansborough Ave, Waterloo, IA 50701-5714 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982096608 | Resources for Human Development,inc. | Community Based Residential Treatment Facility, Mental Illness | 1146 Blairs Ferry Rd Ne, Suite 2, Cedar Rapids, IA 52402-1274 | 2015-03-04 |
| 1447658984 | Judy Alexander | Community Based Residential Treatment Facility, Mental Illness | 2219 W Hills Dr, Fairfield, IA 52556-4739 | 2014-12-16 |
| 1861824617 | Kingston Hill, Inc. | Community Based Residential Treatment Facility, Mental Illness | 202 12th St Nw, Cedar Rapids, IA 52405-3913 | 2013-08-04 |
| 1043554629 | Dac, Inc | Community Based Residential Treatment Facility, Mental Illness | 18720 250th Ave, Bellevue, IA 52031-8202 | 2012-11-20 |
| 1093937260 | Scenic Acres | Community Based Residential Treatment Facility, Mental Illness | 23105 Granite Avenue, Saint Olaf, IA 52074-8049 | 2007-05-03 |
| 1184745424 | Urban Dreams | Community Based Residential Treatment Facility, Mental Illness | 1410 6th Ave, Des Moines, IA 50314-2801 | 2007-04-03 |
| 1013044643 | Community Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 13241 County Home Road, E23, Scotch Grove, IA 52310 | 2007-02-28 |
| 1104951193 | Partnership for Progress | Community Based Residential Treatment Facility, Mental Illness | 60191 Willow St, Atlantic, IA 50022-8172 | 2007-02-22 |
| 1558402271 | Mosaic | Community Based Residential Treatment Facility, Mental Illness | 600 9th Avenue, Council Bluffs, IA 51501-0000 | 2007-02-08 |
| 1023166576 | Plymouth Life, Inc. | Community Based Residential Treatment Facility, Mental Illness | 214 Plymouth St Se, Le Mars, IA 51031-3631 | 2007-01-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.