Provider Demographics
NPI:1851427637
Name:VILLAGE ENTERPRISES, INC.
Entity type:Organization
Organization Name:VILLAGE ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINBOTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:515-451-9392
Mailing Address - Street 1:1208 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5424
Mailing Address - Country:US
Mailing Address - Phone:515-232-2014
Mailing Address - Fax:515-232-2014
Practice Address - Street 1:1208 CLARK AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5424
Practice Address - Country:US
Practice Address - Phone:515-232-2014
Practice Address - Fax:515-232-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05001104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1013391Medicaid