Provider Demographics
NPI:1275899312
Name:GRINSTEAD, PIERCE & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GRINSTEAD, PIERCE & ASSOCIATES, LLC
Other - Org Name:O'ROURKE, GRINSTEAD, PIERCE & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRINSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:319-754-8035
Mailing Address - Street 1:610 N 4TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-5055
Mailing Address - Country:US
Mailing Address - Phone:319-754-8035
Mailing Address - Fax:319-754-9213
Practice Address - Street 1:610 N 4TH ST STE 110
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-5055
Practice Address - Country:US
Practice Address - Phone:319-754-8035
Practice Address - Fax:319-754-9213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-03
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06627104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========Medicaid