Provider Demographics
NPI:1457581381
Name:INDEPENDENT CHILD & ADULT SERVICES, INC
Entity Type:Organization
Organization Name:INDEPENDENT CHILD & ADULT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:319-472-4501
Mailing Address - Street 1:905 D AVE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-1368
Mailing Address - Country:US
Mailing Address - Phone:319-472-4501
Mailing Address - Fax:319-472-4510
Practice Address - Street 1:905 D AVE
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:IA
Practice Address - Zip Code:52349-1368
Practice Address - Country:US
Practice Address - Phone:319-472-4501
Practice Address - Fax:319-472-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable