Provider Demographics
NPI:1124386735
Name:CENTRAL IOWA RECOVERY
Entity Type:Organization
Organization Name:CENTRAL IOWA RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CPRP
Authorized Official - Phone:515-832-9550
Mailing Address - Street 1:500 FAIRMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-3209
Mailing Address - Country:US
Mailing Address - Phone:515-832-9550
Mailing Address - Fax:515-832-9554
Practice Address - Street 1:500 FAIRMEADOW DR
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-3209
Practice Address - Country:US
Practice Address - Phone:515-832-9550
Practice Address - Fax:515-832-9554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMILTON COUNTY SOCIAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health