Provider Demographics
NPI:1265600688
Name:IDA SERVICES, INC.
Entity type:Organization
Organization Name:IDA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-365-4339
Mailing Address - Street 1:651 1ST ST
Mailing Address - Street 2:PO BOX 16
Mailing Address - City:BATTLE CREEK
Mailing Address - State:IA
Mailing Address - Zip Code:51006-5001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:651 1ST ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:IA
Practice Address - Zip Code:51006
Practice Address - Country:US
Practice Address - Phone:712-365-4339
Practice Address - Fax:712-365-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAW1207Medicaid
IAW1431Medicaid
IAW5021Medicaid
IAW0519Medicaid
IAW1430Medicaid
IAW5020Medicaid
IAW1425Medicaid
IAW1205Medicaid