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General NPI Number Information
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NPI Number | 1548417660
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Entity Type | Organization
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Legal Business Name | WARREN COUNTY CASE MANAGEMENT
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 301 N BUXTON ST SUITE 107
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City | INDIANOLA
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State | IA
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Zip | 50125-1847
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Country | US
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Telephone | 515-961-1145
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Fax | 515-961-1142
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Provider Business Mailing Address
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Address Line | 1011 N JEFFERSON WAY SUITE 900
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City | INDIANOLA
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State | IA
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Zip | 50125-1759
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Country | US
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Telephone | 515-961-1145
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Fax | 515-961-1142
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Authorized Official
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Title or Position | CPC ADMINISTRATOR
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Name | MRS. KRISTI DIERKING
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Credential | MSW
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Telephone | 515-961-1145
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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