Provider Demographics
NPI:1811534910
Name:CEDAR CIRCLE MENTAL HEALTH AND WELLNESS PC
Entity type:Organization
Organization Name:CEDAR CIRCLE MENTAL HEALTH AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:319-290-6245
Mailing Address - Street 1:4451 W BENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-9700
Mailing Address - Country:US
Mailing Address - Phone:319-290-6245
Mailing Address - Fax:
Practice Address - Street 1:741 SOUTH ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:IA
Practice Address - Zip Code:50648-9397
Practice Address - Country:US
Practice Address - Phone:319-252-8718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-08
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty