Provider Demographics
NPI:1124199872
Name:FOCUS-FAMILY OPTIONS & COMMUNITY SUPPORTS, INC
Entity Type:Organization
Organization Name:FOCUS-FAMILY OPTIONS & COMMUNITY SUPPORTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:LANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-323-4024
Mailing Address - Street 1:501 S MAIN ST
Mailing Address - Street 2:STE 2B
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-6522
Mailing Address - Country:US
Mailing Address - Phone:712-323-4024
Mailing Address - Fax:712-323-0032
Practice Address - Street 1:501 S MAIN ST
Practice Address - Street 2:STE 2B
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-6522
Practice Address - Country:US
Practice Address - Phone:712-323-4024
Practice Address - Fax:712-323-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0266064Medicaid
IA0765669Medicaid
IA0280511Medicaid
IA1280511Medicaid
KS200326900AMedicaid