Provider Demographics
NPI:1841354834
Name:ECHO PLUS INC
Entity type:Organization
Organization Name:ECHO PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:YOUNGBLUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-336-4052
Mailing Address - Street 1:1808 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1248
Mailing Address - Country:US
Mailing Address - Phone:712-336-4052
Mailing Address - Fax:712-336-4052
Practice Address - Street 1:1808 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1248
Practice Address - Country:US
Practice Address - Phone:712-336-4052
Practice Address - Fax:712-336-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0121111320900000X, 251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0121111Medicaid