Provider Demographics
NPI:1255929717
Name:NEUROBEHAVIORAL SERVICES OF IOWA
Entity type:Organization
Organization Name:NEUROBEHAVIORAL SERVICES OF IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:R. JUSTICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAIMAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-515-4874
Mailing Address - Street 1:10306 ELLISON CIR STE 710
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1024
Mailing Address - Country:US
Mailing Address - Phone:402-515-4874
Mailing Address - Fax:
Practice Address - Street 1:309 COURT AVE STE 829
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2236
Practice Address - Country:US
Practice Address - Phone:402-515-4874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities