Provider Demographics
NPI:1316059496
Name:LUTHERAN FAMILY SERVICE
Entity type:Organization
Organization Name:LUTHERAN FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATHIS-PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-526-8637
Mailing Address - Street 1:409 KENYON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5718
Mailing Address - Country:US
Mailing Address - Phone:515-573-3138
Mailing Address - Fax:515-573-3130
Practice Address - Street 1:409 KENYON RD
Practice Address - Street 2:SUITE C
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5718
Practice Address - Country:US
Practice Address - Phone:515-573-3138
Practice Address - Fax:515-573-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable