Provider Demographics
NPI:1053635292
Name:FAMILY DIRECTIONS OF IOWA
Entity Type:Organization
Organization Name:FAMILY DIRECTIONS OF IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RENFROW
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:515-255-9490
Mailing Address - Street 1:1211 VINE ST
Mailing Address - Street 2:SUITE 2140
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4472
Mailing Address - Country:US
Mailing Address - Phone:515-255-9490
Mailing Address - Fax:515-279-5163
Practice Address - Street 1:1211 VINE ST
Practice Address - Street 2:SUITE 2140
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-4472
Practice Address - Country:US
Practice Address - Phone:515-255-9490
Practice Address - Fax:515-279-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04652251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health