Provider Demographics
NPI:1972008720
Name:ALL THOSE YESTERDAYS
Entity Type:Organization
Organization Name:ALL THOSE YESTERDAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:(T)LMHC, IADC, CCDP
Authorized Official - Phone:712-363-5886
Mailing Address - Street 1:22 STONEYBROOK CIR SW
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-5806
Mailing Address - Country:US
Mailing Address - Phone:712-363-5886
Mailing Address - Fax:
Practice Address - Street 1:22 STONEYBROOK CIR SW
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5806
Practice Address - Country:US
Practice Address - Phone:712-363-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility