Provider Demographics
NPI:1376512160
Name:AREA SUBSTANCE ABUSE COUNCIL
Entity Type:Organization
Organization Name:AREA SUBSTANCE ABUSE COUNCIL
Other - Org Name:NEW DIRECTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOESENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-390-4611
Mailing Address - Street 1:217 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4305
Mailing Address - Country:US
Mailing Address - Phone:563-243-2124
Mailing Address - Fax:563-243-2190
Practice Address - Street 1:250 20TH AVE N STE 250
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2506
Practice Address - Country:US
Practice Address - Phone:563-243-2124
Practice Address - Fax:563-243-2190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AREA SUBSTANCE ABUSE COUNCIL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101YA0400X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========OtherTAX ID