Provider Demographics
NPI:1417246570
Name:SHIP-ADMINISTRATIVE SERVICES
Entity Type:Organization
Organization Name:SHIP-ADMINISTRATIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-222-6369
Mailing Address - Street 1:1520 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-1716
Mailing Address - Country:US
Mailing Address - Phone:712-222-6369
Mailing Address - Fax:712-222-6216
Practice Address - Street 1:705 DOUGLAS ST
Practice Address - Street 2:SUITE 522
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1048
Practice Address - Country:US
Practice Address - Phone:712-277-2007
Practice Address - Fax:712-277-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty