Provider Demographics
NPI:1891891917
Name:OPPORTUNITY HOMES INC
Entity Type:Organization
Organization Name:OPPORTUNITY HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCH-SEEHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-382-8140
Mailing Address - Street 1:606 IOWA AVE
Mailing Address - Street 2:PO BOX 166
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-1237
Mailing Address - Country:US
Mailing Address - Phone:563-382-8140
Mailing Address - Fax:563-382-5049
Practice Address - Street 1:606 IOWA AVE
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-1237
Practice Address - Country:US
Practice Address - Phone:563-382-8140
Practice Address - Fax:563-382-5049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0234351Medicaid
IA0241349Medicaid
IA0745018Medicaid