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General NPI Number Information
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NPI Number | 1689919094
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Entity Type | Organization
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Legal Business Name | CITY OF COUNCIL BLUFFS
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 209 PEARL ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-0826
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Country | US
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Telephone | 712-328-4666
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Fax | 712-328-4917
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Provider Business Mailing Address
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Address Line | 209 PEARL ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-0826
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Country | US
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Telephone | 712-328-4666
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Fax | 712-328-4917
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DONN DIERKS
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Credential |
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Telephone | 712-328-4666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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