Provider Demographics
NPI:1184881617
Name:MIDAS COUNCIL OF GOVERNMENTS
Entity type:Organization
Organization Name:MIDAS COUNCIL OF GOVERNMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WELDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-576-7183
Mailing Address - Street 1:602 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4604
Mailing Address - Country:US
Mailing Address - Phone:515-576-7183
Mailing Address - Fax:515-576-7184
Practice Address - Street 1:602 1ST AVE S
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4604
Practice Address - Country:US
Practice Address - Phone:515-576-7183
Practice Address - Fax:515-576-7184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0219998Medicaid