Provider Demographics
NPI:1174867782
Name:DAC, INC
Entity Type:Organization
Organization Name:DAC, INC
Other - Org Name:ANDREW JACKSON CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-652-5252
Mailing Address - Street 1:1710 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-9214
Mailing Address - Country:US
Mailing Address - Phone:563-652-5252
Mailing Address - Fax:563-652-4872
Practice Address - Street 1:18720 250TH AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:IA
Practice Address - Zip Code:52031-8202
Practice Address - Country:US
Practice Address - Phone:563-672-3800
Practice Address - Fax:563-672-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA480114320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness