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General NPI Number Information
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NPI Number | 1376669994
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Entity Type | Organization
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Legal Business Name | POWESHIEK COUNTY CASE MANAGEMENT
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 W. STREET
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City | GRINNELL
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State | IA
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Zip | 50112
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Country | US
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Telephone | 641-236-9199
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Fax | 641-236-0599
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Provider Business Mailing Address
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Address Line | 120 W. STREET
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City | GRINNELL
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State | IA
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Zip | 50112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CM SUPERVISOR
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Name | DAWN ROTH
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Credential |
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Telephone | 641-236-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 0256834
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License Number State | IA
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