NPIMap

Organization Active NPI

Department of Human Services Glenwood Resource Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Glenwood, IA
National Provider Identifier
1972650158
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DEPARTMENT OF HUMAN SERVICES GLENWOOD RESOURCE CENTER
Practice address
711 S Vine St
Glenwood, IA 51534-1927
Phone
(712) 527-4811
Fax
(712) 525-1405
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Authorized official

Name
Ms. Randi R Cloyed
Title
Treatment Service Director
Phone
(712) 525-1395

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

711 S Vine St
Glenwood, IA 51534-1927

Mailing address

711 S Vine St
Glenwood, IA 51534-1927
Phone (712) 527-4811

Other identifiers 1

IdentifierTypeStateIssuer
0136952OtherIAWAIVER

Other names 1

  • Family Support & Outreach Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Department of Human Services Glenwood Resource Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219881600000",
    "number": "1972650158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 S VINE ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341927",
            "telephone_number": "712-527-4811",
            "fax_number": "712-525-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 S VINE ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341927",
            "telephone_number": "712-527-4811",
            "fax_number": "712-525-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HUMAN SERVICES GLENWOOD RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-08-28",
        "status": "A",
        "authorized_official_last_name": "CLOYED",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "TREATMENT SERVICE DIRECTOR",
        "authorized_official_telephone_number": "712-525-1395",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAIVER",
            "identifier": "0136952",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Support & Outreach Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glenwood, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.