Provider Demographics
NPI:1295739951
Name:THE EASTER SEAL SOCIETY OF IOWA, INC.
Entity type:Organization
Organization Name:THE EASTER SEAL SOCIETY OF IOWA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:515-289-1933
Mailing Address - Street 1:PO BOX 4002
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50333-4002
Mailing Address - Country:US
Mailing Address - Phone:515-289-1933
Mailing Address - Fax:515-289-1281
Practice Address - Street 1:401 NE 66TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-1243
Practice Address - Country:US
Practice Address - Phone:515-289-1933
Practice Address - Fax:515-289-1281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0088625Medicaid
IA0226977OtherARO - ADULT REHAB OPTION