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NPI 1164631214 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Corydon, IA
Provider details
- NPI number
- 1164631214
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mendy Middlebrook, Temporary Administrator(641) 872-1524
- License
- RMR-413 (IA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense RMR-413 (IA)
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
401 S Washington St
Corydon, IA 50060-1745
Phone: (641) 872-1524
Fax: (641) 872-2843
Street-level locationGet directions
Mailing address
401 S Washington St
Corydon, IA 50060-1745
Registry dates
- Enumerated
- 2007-05-22
- Last updated
- 2008-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.