Provider Demographics
NPI:1801953807
Name:UNLIMITED SERVICE, INC.
Entity type:Organization
Organization Name:UNLIMITED SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ACCOUNTING
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:VONDERHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-252-1062
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:IA
Mailing Address - Zip Code:52052-0069
Mailing Address - Country:US
Mailing Address - Phone:563-252-1062
Mailing Address - Fax:563-252-1361
Practice Address - Street 1:308 S. RIVER PARK DR.
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:IA
Practice Address - Zip Code:52052-0069
Practice Address - Country:US
Practice Address - Phone:563-252-1062
Practice Address - Fax:563-252-1361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA320900000320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1442368Medicaid
IA0288043Medicaid
IA0442368Medicaid