Provider Demographics
NPI:1740651389
Name:ACCESS 2 INDEPENDENCE OF THE EASTERN CORRIDOR, INC.
Entity type:Organization
Organization Name:ACCESS 2 INDEPENDENCE OF THE EASTERN CORRIDOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-338-3870
Mailing Address - Street 1:1556 S 1ST AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6007
Mailing Address - Country:US
Mailing Address - Phone:319-338-3870
Mailing Address - Fax:
Practice Address - Street 1:1556 S 1ST AVE
Practice Address - Street 2:SUITE B
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6007
Practice Address - Country:US
Practice Address - Phone:319-338-3870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable