| Organization Name: | BIRCHWOOD WELLNESS |
| NPI Number: | 1124405055 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUE IRWIN (BILLING MANAGER) |
| Mailing Address: | 6900 Ne 14th St Ste 29 Ankeny |
| State: | IA US |
| Postal Code: | 500238902 |
| Phone Number: | 4409346135 |
| Fax Number: | 4409346147 |
| NPI Enumeration Date: | 04/29/2015 |
| NPI Last Update Date: | 05/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | G-108504 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |