Healthcare Provider Details

I. General information

NPI: 1992831986
Provider Name (Legal Business Name): HUMBOLDT COUNTY CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 MAIN ST COURTHOUSE
DAKOTA CITY IA
50529-5063
US

IV. Provider business mailing address

203 MAIN ST PO BOX 100 COURTHOUSE
DAKOTA CITY IA
50529-5063
US

V. Phone/Fax

Practice location:
  • Phone: 515-332-5205
  • Fax: 515-332-2289
Mailing address:
  • Phone: 515-332-5205
  • Fax: 515-332-2289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateIA

VIII. Authorized Official

Name: MR. DON R ANDERSON
Title or Position: DIRECTOR
Credential:
Phone: 515-332-5205