=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669416764
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF BUTLER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2006
-----------------------------------------------------
Last Update Date | 08/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 428 6TH STREET, BOX 325
-----------------------------------------------------
City | ALLISON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-267-2934
-----------------------------------------------------
Fax | 319-267-2113
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 428 6TH STREET, BOX 325
-----------------------------------------------------
City | ALLISON
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-267-2934
-----------------------------------------------------
Fax | 319-267-2113
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AGENCY DIRECTOR
-----------------------------------------------------
Name | JENNIFER BECKER
-----------------------------------------------------
Credential | R.N., B.S.N.
-----------------------------------------------------
Telephone | 319-267-2934
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------