Olympic Medical LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Ankeny, IA. Organization (NPI-2).
NPI number1710692173
StatusActive
Last updated in NPPESApr 20, 2023
Details
- NPI
- 1710692173
- Entity type
- Organization (NPI-2)
- Legal business name
- Olympic Medical LLC
- Organization subpart
- No
- Enumeration date
- Jan 19, 2023
- Certification date
- Apr 20, 2023
- Last updated
- Apr 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
4823 Ne Oak LnAnkeny, IA 50021-1851
Phone 712-221-5827
Mailing address
4823 Ne Oak LnAnkeny, IA 50021-1851
Phone 712-221-5827
Authorized official
Raymond Agbor
Ceo
7122215827
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