Provider Demographics
NPI:1770635310
Name:HANDICAPPED DEVELOPMENT CENTER
Entity Type:Organization
Organization Name:HANDICAPPED DEVELOPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MCALEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-391-4834
Mailing Address - Street 1:3402 HICKORY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-3305
Mailing Address - Country:US
Mailing Address - Phone:563-391-4834
Mailing Address - Fax:563-391-4931
Practice Address - Street 1:3402 HICKORY GROVE RD
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-3305
Practice Address - Country:US
Practice Address - Phone:563-391-4834
Practice Address - Fax:563-391-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251C00000X, 320900000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0096073Medicaid