Provider Demographics
NPI:1851632962
Name:HALLING WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:HALLING WELLNESS CENTER, INC
Other - Org Name:MANDY J. HALLING ROUSH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:JANEL
Authorized Official - Last Name:HALLING ROUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-334-0505
Mailing Address - Street 1:2535 106TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3766
Mailing Address - Country:US
Mailing Address - Phone:515-334-0505
Mailing Address - Fax:515-334-0510
Practice Address - Street 1:2535 106TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3766
Practice Address - Country:US
Practice Address - Phone:515-334-0505
Practice Address - Fax:515-334-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0489963Medicaid
IA0489963Medicaid