The Collaborative Adult Relationship Experiences Group, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

489DLC-443116 Issued in IA

Legal business name

THE COLLABORATIVE ADULT RELATIONSHIP EXPERIENCES GROUP, LLC

Practice address

2649 Avenue B
Council Bluffs, IA 51501-2105

Phone

(712) 256-0013

NPI assigned

Oct 16, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Julie A Flynn, M.S.

Title

Consumer Relations Director

Phone

(712) 256-0013

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1720331739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 AVENUE B",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515012105",
            "telephone_number": "712-256-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 AVENUE B",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515012105",
            "telephone_number": "712-256-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COLLABORATIVE ADULT RELATIONSHIP EXPERIENCES GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONSUMER RELATIONS DIRECTOR",
        "authorized_official_telephone_number": "712-256-0013",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IA",
            "license": "489DLC-443116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.