DEPARTMENT OF HUMAN SERVICES GLENWOOD RESOURCE CENTER (NPI# 1972650158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972650158 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF HUMAN SERVICES GLENWOOD RESOURCE CENTER |
| Other Organization Name | FAMILY SUPPORT & OUTREACH SERVICES |
| Practice Address |
711 S Vine St Glenwood IA 51534-1927 |
| Practice Telephone | 7125274811 |
| Practice Fax Number | 7125251405 |
| Mailing Telephone | 7125274811 |
| Mailing Fax Number | 7125251405 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2008-08-28 |
| Authorized Official Name | MS. RANDI R CLOYED (TREATMENT SERVICE DIRECTOR) |
| Authorized Official Telephone | 7125251395 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | WAIVER | 0136952 | 01 |
| Other Name | Type Code |
|---|---|
| Family Support & Outreach Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356474019 | Department of Human Services Glenwood Resource Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 S Vine St, Glenwood, IA 51534-1927 | 2007-03-13 |
| 1164589180 | Department of Human Services Glenwood Resource Center | Intermediate Care Facility, Mentally Retarded | 711 S Vine St, Glenwood, IA 51534-1927 | 2007-01-02 |
| Street Address |
711 S VINE ST |
| City | GLENWOOD |
| State | IA |
| Zip Code | 51534-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477513356 | Thomas Arthur King | Dentist | 711 S Vine St, Glenwood, IA 51534-1927 | 2006-03-24 |
| 1285191726 | Inspired Respiratory Services Inc | Respiratory Therapist, Registered | 711 S Vine St, Glenwood, IA 51534-1927 | 2019-02-20 |
| 1326504978 | Alyssa Johnson | Nurse Practitioner | 711 S Vine St, Glenwood, IA 51534-1927 | 2019-02-19 |
| 1225273527 | Katiejo Charmaine Lawton | Occupational Therapist | 711 S Vine St, Glenwood, IA 51534-1927 | 2008-12-16 |
| 1043461809 | Anne L White | Audiologist | 711 S Vine St, Glenwood, IA 51534-1927 | 2008-10-09 |
| 1790933620 | Glenwood Resource Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 S Vine St, Glenwood, IA 51534-1927 | 2008-09-04 |
| 1467618868 | Jason A Krist | Nurse Practitioner | 711 S Vine St, Glenwood Resource Center, State of Iowa, Glenwood, IA 51534-1927 | 2008-08-05 |
| 1083890503 | Edward Lawrence Kelly Jr. | Licensed Practical Nurse | 711 S Vine St, Glenwood, IA 51534-1927 | 2008-01-15 |
| 1538292826 | Kathryn Laughlin Harbor | Pharmacist | 711 S Vine St, Glenwood, IA 51534-1927 | 2007-03-14 |
| 1356474019 | Department of Human Services Glenwood Resource Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 S Vine St, Glenwood, IA 51534-1927 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932421286 | Michael J Hanlon | Pharmacist | 2803 East Kanesville Boulevard, Council Bluffs, IA 51534 | 2010-02-26 |
| 1417143199 | Nancy Goodell Schmailzl | Pharmacist | 1206 Locust, Glenwood, IA 51534 | 2007-09-17 |
| 1639372055 | Margramon P C | Pharmacy | 1206 S Locust St, Glenwood, IA 51534 | 2007-06-06 |
| 1083824791 | Denise Jaye Johnson | Physical Therapist | 212 Independence Ave, Suite 100, Glenwood, IA 51534 | 2007-05-23 |
| 1841355575 | On With Life Extended Service, Ltd. | Skilled Nursing Facility | 714 Lacey St, Glenwood, IA 51534 | 2006-12-22 |
| 1033270913 | Robert F Lothrop Dds PC | Dentist | 112 S Vine, Glenwood, IA 51534 | 2006-12-13 |
| 1689749806 | Tracy A Stromgren | Chiropractor | 24 North Walnut, Glenwood, IA 51534 | 2006-11-22 |
| 1417022096 | Glenwood Family Dentistry PC | Dentist | 514 First St, Glenwood, IA 51534 | 2006-11-21 |
| 1023105855 | Physicians Clinic, Inc. | Durable Medical Equipment & Medical Supplies | 320 Ebaugh Street, Glenwood, IA 51534 | 2006-10-05 |
| 1801018452 | Stromgren Chiropractic Pa | Chiropractor | 24 North Walnut, Glenwood, IA 51534 | 2007-05-03 |
| Find all providers in zip 51534 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780135194 | Genesis Cila Homes Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 441 S Dante Ave, Glenwood, IL 60425-2045 | 2016-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063040111 | Ability United LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 102 N Adams St, Carroll, IA 51401-2821 | 2020-04-01 |
| 1881045706 | Golden Touch Healthcare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7618 Hickman Rd, Windsor Heights, IA 50324-4510 | 2016-06-22 |
| 1518302801 | The Phoenix Group, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 S 37th St Apt F, Council Bluffs, IA 51501-3284 | 2013-05-01 |
| 1720331739 | The Collaborative Adult Relationship Experiences Group, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2649 Avenue B, Council Bluffs, IA 51501-2105 | 2012-10-16 |
| 1407115645 | Anchor Homes, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 501 N 15th St, Clarinda, IA 51632-1632 | 2012-05-09 |
| 1306115365 | Community Living Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8517 Airline Ave, Urbandale, IA 50322-2317 | 2011-12-21 |
| 1033414826 | Tandem Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2901 Douglas Ave Ste D2, Des Moines, IA 50310-5804 | 2011-01-25 |
| 1720284524 | Comprehensive Systems, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1700 Clark Street, Charles City, IA 50616-0457 | 2007-06-27 |
| 1174658637 | Crossroads Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1424 Houser St, Muscatine, IA 52761-2235 | 2007-02-23 |
| 1265578439 | Discovery Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 220 Northland Ct Ne, Cedar Rapids, IA 52402-6226 | 2007-01-29 |
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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.