Provider Demographics
NPI:1982657490
Name:EYERLY BALL COMMUNITY MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:EYERLY BALL COMMUNITY MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIDL-BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-235-8852
Mailing Address - Street 1:1301 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1004
Mailing Address - Country:US
Mailing Address - Phone:515-243-5181
Mailing Address - Fax:515-243-2760
Practice Address - Street 1:1301 CENTER ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1004
Practice Address - Country:US
Practice Address - Phone:515-243-5181
Practice Address - Fax:515-243-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07458OtherBLUE CROSS BLUE SHIELD
IA0074583Medicaid
IA07458Medicare ID - Type Unspecified