Provider Demographics
NPI:1972845022
Name:IOWA EDUCATIONAL SERVICES FOR THE BLIND AND VISUALLY IMPAIRED
Entity Type:Organization
Organization Name:IOWA EDUCATIONAL SERVICES FOR THE BLIND AND VISUALLY IMPAIRED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BODDICKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-472-5221
Mailing Address - Street 1:1002 G AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-1341
Mailing Address - Country:US
Mailing Address - Phone:319-472-5221
Mailing Address - Fax:319-472-5174
Practice Address - Street 1:1002 G AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-1341
Practice Address - Country:US
Practice Address - Phone:319-472-5221
Practice Address - Fax:319-472-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)