Basic Information
| Provider Information | |||||||||
| NPI: | 1427504216 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRANSITIONAL SERVICES OF IOWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1221 PIERCE ST | ||||||||
| Address2: | |||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511051418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122550204 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1221 PIERCE ST | ||||||||
| Address2: | |||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511051418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122550232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 08/31/2016 | ||||||||
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| AuthorizedOfficialLastName: | JACKSON | ||||||||
| AuthorizedOfficialFirstName: | JACOB | ||||||||
| AuthorizedOfficialMiddleName: | JERRY | ||||||||
| AuthorizedOfficialTitleorPosition: | SUBSTANCE ABUSE COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 7122550204 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CADC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.