Provider Demographics
NPI:1669611646
Name:LAWSON TREATMENT SERVICES, LLC
Entity type:Organization
Organization Name:LAWSON TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:ACADC, LBSW
Authorized Official - Phone:712-260-9660
Mailing Address - Street 1:2701 MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:RUTHVEN
Mailing Address - State:IA
Mailing Address - Zip Code:51358-7741
Mailing Address - Country:US
Mailing Address - Phone:712-260-9660
Mailing Address - Fax:
Practice Address - Street 1:2701 MITCHELL ST
Practice Address - Street 2:
Practice Address - City:RUTHVEN
Practice Address - State:IA
Practice Address - Zip Code:51358-7741
Practice Address - Country:US
Practice Address - Phone:712-260-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1298251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA600490555Medicaid