Provider Demographics
NPI:1932296399
Name:MID IOWA COMMUNITY ACTION, INC
Entity Type:Organization
Organization Name:MID IOWA COMMUNITY ACTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCATEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-752-7162
Mailing Address - Street 1:1001 S 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-3662
Mailing Address - Country:US
Mailing Address - Phone:641-752-7162
Mailing Address - Fax:641-754-1007
Practice Address - Street 1:126 S KELLOGG AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-7030
Practice Address - Country:US
Practice Address - Phone:515-956-3312
Practice Address - Fax:515-956-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0051458Medicaid
IA0046425Medicaid