Provider Demographics
NPI:1346560646
Name:RUMPELSTILTSKIN INC.
Entity type:Organization
Organization Name:RUMPELSTILTSKIN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:OLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:319-366-0453
Mailing Address - Street 1:425 2ND ST SE STE 1275
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-1819
Mailing Address - Country:US
Mailing Address - Phone:319-366-0453
Mailing Address - Fax:
Practice Address - Street 1:425 2ND ST SE STE 1275
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1819
Practice Address - Country:US
Practice Address - Phone:319-366-0453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty