OrganizationActive
Self-Awareness, LLC
NPI 1760859680 · Substance Use Disorder Rehabilitation Clinic/Center · Des Moines, IA
Provider details
- NPI number
- 1760859680
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jerome Miller, Ececutive Director/Counselor(515) 277-0320
- License
- 1377 (IA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2301 Forest Ave
Des Moines, IA 50311-3113
Phone: (515) 277-0320
Fax: (515) 277-0358
Approximate (ZIP-level) locationGet directions
Mailing address
2301 Forest Ave
Des Moines, IA 50311-3113
Registry dates
- Enumerated
- 2015-08-26
- Last updated
- 2015-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.