Provider Demographics
NPI:1194867655
Name:SKYLINE CENTER INC
Entity Type:Organization
Organization Name:SKYLINE CENTER INC
Other - Org Name:CLINTON ASSOCIATION FOR DAYCARE OF HANDICAPPED CHILDREN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD
Authorized Official - Phone:563-243-4065
Mailing Address - Street 1:PO BOX 3064
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-3064
Mailing Address - Country:US
Mailing Address - Phone:563-243-4065
Mailing Address - Fax:563-243-9901
Practice Address - Street 1:2600 N 4TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-1840
Practice Address - Country:US
Practice Address - Phone:563-243-4065
Practice Address - Fax:563-243-9901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251E00000XAgenciesHome Health
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0243410OtherARO
IA0228700OtherARO
IA0672949Medicaid
IA0672949Medicaid