Provider Demographics
NPI:1033379565
Name:REGIONAL ENTERPRISES INC
Entity Type:Organization
Organization Name:REGIONAL ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-682-7511
Mailing Address - Street 1:1001 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-6427
Mailing Address - Country:US
Mailing Address - Phone:641-682-7511
Mailing Address - Fax:641-683-2862
Practice Address - Street 1:312 E ALTA VISTA AVE
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-1413
Practice Address - Country:US
Practice Address - Phone:641-682-7511
Practice Address - Fax:641-683-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1265324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1265OtherSTATE LICENSE