Provider Demographics
NPI:1912058967
Name:CENTER FOR HUMAN DEVELOPMENT, INC
Entity Type:Organization
Organization Name:CENTER FOR HUMAN DEVELOPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEHILL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:712-239-1695
Mailing Address - Street 1:1504 HIAWATHA TRL
Mailing Address - Street 2:PO BOX 1326
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-4325
Mailing Address - Country:US
Mailing Address - Phone:712-239-1695
Mailing Address - Fax:712-239-1695
Practice Address - Street 1:1504 HIAWATHA TRL
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-4325
Practice Address - Country:US
Practice Address - Phone:712-239-1695
Practice Address - Fax:712-239-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1012393Medicaid