Provider Demographics
NPI:1508966557
Name:GOOD CONNECTIONS, INC
Entity Type:Organization
Organization Name:GOOD CONNECTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LARSEN-BOLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-865-3027
Mailing Address - Street 1:1109 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-1818
Mailing Address - Country:US
Mailing Address - Phone:515-432-6911
Mailing Address - Fax:319-865-3110
Practice Address - Street 1:823 KEELER ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-2729
Practice Address - Country:US
Practice Address - Phone:515-433-2100
Practice Address - Fax:515-432-5544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36314103TC0700X
IA013931041C0700X
IA00235106H00000X
IA00240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5106914Medicaid
IA5106914Medicaid