Provider Demographics
NPI:1043581648
Name:ZION INTEGRATED BEHAVIORAL HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:ZION INTEGRATED BEHAVIORAL HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-243-5091
Mailing Address - Street 1:601 WALNUT ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1571
Mailing Address - Country:US
Mailing Address - Phone:712-243-5091
Mailing Address - Fax:712-243-1337
Practice Address - Street 1:615 NORTHWEST RD
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1199
Practice Address - Country:US
Practice Address - Phone:712-246-4832
Practice Address - Fax:712-246-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1267261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA68236OtherWELLMARK - BCBS