Provider Demographics
NPI:1083784912
Name:IDA SERVICES, INC.
Entity Type:Organization
Organization Name:IDA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-365-4339
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:IA
Mailing Address - Zip Code:51006-0016
Mailing Address - Country:US
Mailing Address - Phone:712-365-4339
Mailing Address - Fax:712-365-4566
Practice Address - Street 1:651 FIRST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:IA
Practice Address - Zip Code:51006-0016
Practice Address - Country:US
Practice Address - Phone:712-365-4339
Practice Address - Fax:712-365-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA251C00000X
251E00000X, 251S00000X, 251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0240358Medicaid
IAW0721Medicaid
IA0124891Medicaid
IAW0519Medicaid
IAW5020Medicaid
IA1240358Medicaid
IAW1300Medicaid
IAW0720Medicaid
IAW0722Medicaid
IAW1430Medicaid
IAW1311Medicaid
IAW1431Medicaid
IAW0719Medicaid
IAW1414Medicaid
IAW1425Medicaid
IAW5021Medicaid