Provider Demographics
NPI:1114292661
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:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-0034
Mailing Address - Country:US
Mailing Address - Phone:712-243-2606
Mailing Address - Fax:712-560-3889
Practice Address - Street 1:2307 OLIVE ST APT 1
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-9773
Practice Address - Country:US
Practice Address - Phone:712-243-2606
Practice Address - Fax:712-243-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
IA1267324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA68236OtherWELLMARK-BCBS