Provider Demographics
NPI:1215090451
Name:EMMET COUNTY CASE MANAGEMENT
Entity type:Organization
Organization Name:EMMET COUNTY CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGEMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-362-2452
Mailing Address - Street 1:609 1ST AVE N
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-2245
Mailing Address - Country:US
Mailing Address - Phone:712-362-2452
Mailing Address - Fax:712-362-7835
Practice Address - Street 1:609 1ST AVE N
Practice Address - Street 2:SUITE 5
Practice Address - City:ESTHERVILLE
Practice Address - State:IA
Practice Address - Zip Code:51334-2245
Practice Address - Country:US
Practice Address - Phone:712-362-2452
Practice Address - Fax:712-362-7835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0742122Medicaid