Provider Demographics
NPI:1932280534
Name:MID-SIOUX OPPORTUNITY, INC.
Entity Type:Organization
Organization Name:MID-SIOUX OPPORTUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-786-2001
Mailing Address - Street 1:418 S MARION ST
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:IA
Mailing Address - Zip Code:51050-1102
Mailing Address - Country:US
Mailing Address - Phone:712-786-2001
Mailing Address - Fax:712-786-3250
Practice Address - Street 1:418 S MARION ST
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:IA
Practice Address - Zip Code:51050-1102
Practice Address - Country:US
Practice Address - Phone:712-786-2001
Practice Address - Fax:712-786-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251J00000XAgenciesNursing Care
Not Answered251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0036095Medicaid