Provider Demographics
NPI:1730231937
Name:ALLAMAKEE COUNTY CASE MANAGEMENT
Entity type:Organization
Organization Name:ALLAMAKEE COUNTY CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-568-6227
Mailing Address - Street 1:110 ALLAMAKEE ST
Mailing Address - Street 2:
Mailing Address - City:WAUKON
Mailing Address - State:IA
Mailing Address - Zip Code:52172-1744
Mailing Address - Country:US
Mailing Address - Phone:563-568-6227
Mailing Address - Fax:563-568-6417
Practice Address - Street 1:110 ALLAMAKEE ST
Practice Address - Street 2:
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-1744
Practice Address - Country:US
Practice Address - Phone:563-568-6227
Practice Address - Fax:563-568-6417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0082974Medicaid
IA0744938Medicaid
IA0288522Medicaid