Provider Demographics
NPI:1336487016
Name:EYWA HEALTH, INC
Entity Type:Organization
Organization Name:EYWA HEALTH, INC
Other - Org Name:IOWA CENTER FOR PSYCHOLOGICAL HEALTH, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OUTPATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:TALLULAH
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-554-0878
Mailing Address - Street 1:147 PAINE ST SE STE J
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1003
Mailing Address - Country:US
Mailing Address - Phone:515-554-0878
Mailing Address - Fax:515-777-1719
Practice Address - Street 1:333 SW 9TH ST
Practice Address - Street 2:SUITE J
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-4440
Practice Address - Country:US
Practice Address - Phone:515-777-3075
Practice Address - Fax:515-777-1719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY ACCESS & LIFE MANAGEMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-30
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0072361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA600993023Medicaid
IA600993023Medicaid