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General NPI Number Information
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NPI Number | 1669547428
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Entity Type | Organization
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Legal Business Name | POCAHONTAS COUNTY HOME CARE AIDE AGENCY
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 21 3RD AVE NE
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City | POCAHONTAS
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State | IA
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Zip | 50574-1614
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Country | US
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Telephone | 712-335-4587
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Fax | 712-335-3929
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Provider Business Mailing Address
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Address Line | 21 3RD AVE NE
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City | POCAHONTAS
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State | IA
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Zip | 50574-1614
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Country | US
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Telephone | 712-335-4587
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Fax | 712-335-3929
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MS. JILL SUE CONLIN
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Credential | LBSW
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Telephone | 712-335-4587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | IA
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