Provider Demographics
NPI:1225195092
Name:RAGTIME INDUSTRIES
Entity type:Organization
Organization Name:RAGTIME INDUSTRIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-932-7813
Mailing Address - Street 1:116 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531-1624
Mailing Address - Country:US
Mailing Address - Phone:641-932-7813
Mailing Address - Fax:641-932-7814
Practice Address - Street 1:116 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531-1624
Practice Address - Country:US
Practice Address - Phone:641-932-7813
Practice Address - Fax:641-932-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0248542Medicaid
IA0174441Medicaid