Provider Demographics
NPI:1952434680
Name:A1 ADDICTIONS RECOVERY CENTER
Entity Type:Organization
Organization Name:A1 ADDICTIONS RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CADC
Authorized Official - Phone:515-993-4246
Mailing Address - Street 1:102 AND ONE HALF NILE KINNICK DRIVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003
Mailing Address - Country:US
Mailing Address - Phone:515-993-4246
Mailing Address - Fax:515-993-4256
Practice Address - Street 1:532 8TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-4533
Practice Address - Country:US
Practice Address - Phone:515-993-4246
Practice Address - Fax:515-993-4245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health