Crossroads Of Western Iowa

LBN: Trivium Life Services
Crossroads Of Western Iowa is an health care organization with primary practice located at 1851 Madison Ave Ste 718 , Council Bluffs IA 51503-3602. The organization recently has 5 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Ambulatory Health Care Facilities / Adult Day Care, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Agencies / Day Training, Developmentally Disabled Services is the primary health care specialty. Trivium Life Services can be contacted via phone (712) 256-7888, or through Zima, Darian Matthew via phone (712) 256-7888.

Contact Information

Primary practice address
1851 Madison Ave Ste 718 Council Bluffs IA 51503-3602
Phone: (712) 256-7888
Fax: (712) 256-6502
Website:
Map and Directions
Authorized official contact:
Name: Zima, Darian Matthew
Phone: (712) 256-7888

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1841327673
LBN Legal business name Trivium Life Services
DBA Doing business as Crossroads Of Western Iowa
Authorized official Zima, Darian Matthew
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2007
Last updated Dec 15th, 2021 - about 3 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 1841327673 NPPES
Iowa MEDICAID 0761718
Iowa MEDICAID 0239913
Iowa MEDICAID 0106476

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