Tanager Place Pmic

LBN: Tanager Place
Tanager Place Pmic is an health care organization with primary practice located at 2309 C St Sw , Cedar Rapids IA 52404-3707. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Tanager Place can be contacted via phone (319) 365-9164, or through Humiston, Jeff via phone (319) 365-9164.

Contact Information

Primary practice address
2309 C St Sw Cedar Rapids IA 52404-3707
Phone: (319) 365-9164
Fax: (319) 365-6411
Website:
Map and Directions
Authorized official contact:
Name: Humiston, Jeff
Phone: (319) 365-9164

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X 57PM-0005 Iowa

Profile Details

NPI number 1114083474
LBN Legal business name Tanager Place
DBA Doing business as Tanager Place Pmic
Authorized official Humiston, Jeff
Entity Organization
Organization subpart 1 No
Enumeration date Dec 29th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114083474 NPPES
Iowa MEDICAID 0047639

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