NPIMap

Organization Active NPI

North Iowa Juvenile Detention Services

  • Mental Illness Community Based Residential Treatment Facility
  • Waterloo, IA
National Provider Identifier
1174976757
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
NORTH IOWA JUVENILE DETENTION SERVICES
Practice address
1440 W Dunkerton Rd
Waterloo, IA 50703-9648
Phone
(319) 291-2455
Fax
(319) 291-2464
NPI assigned
Jul 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amber Lacina, BSN, RN, MSN, APMHNPNPI 1033436480
Title
Medical Director
Phone
(319) 291-2455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Nursing Facility/Intermediate Care Facility 313M00000X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1440 W Dunkerton Rd
Waterloo, IA 50703-9648

Mailing address

1440 W Dunkerton Rd
Waterloo, IA 50703-9648
Phone (319) 291-2455

National Provider Directory

National Provider Directory
Tax ID family
North Iowa Juvenile Detention Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1440 W Dunkerton Rd
Waterloo, IA 50703
Phone (319) 291-2455

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1174976757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2455",
            "fax_number": "319-291-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 W DUNKERTON RD",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507039648",
            "telephone_number": "319-291-2455",
            "fax_number": "319-291-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH IOWA JUVENILE DETENTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "LACINA",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "319-291-2455",
        "authorized_official_credential": "BSN, RN, MSN, APMHNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.