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General NPI Number Information
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NPI Number | 1730187113
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Entity Type | Organization
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Legal Business Name | COUNTY OF JEFFERSON
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 06/17/2011
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Provider Practice Location Address
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Address Line | 1212 WALNUT ST
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City | OSKALOOSA
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State | KS
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Zip | 66066-4200
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Country | US
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Telephone | 785-863-2447
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Fax | 785-863-3323
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Provider Business Mailing Address
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Address Line | 1212 WALNUT ST
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City | OSKALOOSA
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State | KS
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Zip | 66066-4200
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Country | US
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Telephone | 785-863-2447
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Fax | 785-863-3323
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Authorized Official
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Title or Position | HOME CARE DIRECTOR
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Name | JEANNE MARIE CZOCH
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Credential | RN, BSN
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Telephone | 785-863-2447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | Z044001
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License Number State | KS
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