Organization Name: | INTEGRATIVE PSYCHIATRY OF IOWA PC |
NPI Number: | 1003060161 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANETA FONG TANSEY (DIRECTOR) |
Mailing Address: | 221 E College St Suite 211 Iowa City |
State: | IA US |
Postal Code: | 522401699 |
Phone Number: | 3193373313 |
Fax Number: | 3193370686 |
NPI Enumeration Date: | 11/14/2008 |
NPI Last Update Date: | 11/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 32238 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |