Provider Demographics
NPI:1902619117
Name:BROADLAWNS MEDICAL CENTER
Entity type:Organization
Organization Name:BROADLAWNS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-985-9353
Mailing Address - Street 1:1801 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1597
Mailing Address - Country:US
Mailing Address - Phone:515-282-2200
Mailing Address - Fax:
Practice Address - Street 1:1212 E MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50315-4362
Practice Address - Country:US
Practice Address - Phone:515-282-8125
Practice Address - Fax:515-282-8139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROADLAWNS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness