Provider Demographics
NPI:1518092097
Name:AGING RESOURCES OF CENTRAL IOWA
Entity Type:Organization
Organization Name:AGING RESOURCES OF CENTRAL IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-255-6142
Mailing Address - Street 1:5835 GRAND AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-1437
Mailing Address - Country:US
Mailing Address - Phone:515-255-6142
Mailing Address - Fax:515-255-9442
Practice Address - Street 1:5835 GRAND AVE STE 106
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-1437
Practice Address - Country:US
Practice Address - Phone:515-255-6142
Practice Address - Fax:515-255-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0498642251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0498642Medicaid