Provider Demographics
NPI:1285622720
Name:COUNTY OF KEOKUK
Entity type:Organization
Organization Name:COUNTY OF KEOKUK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HELMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-622-3575
Mailing Address - Street 1:101 S MAIN ST
Mailing Address - Street 2:COURTHOUSE
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1419
Mailing Address - Country:US
Mailing Address - Phone:641-622-3575
Mailing Address - Fax:641-622-1052
Practice Address - Street 1:101 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:SIGOURNEY
Practice Address - State:IA
Practice Address - Zip Code:52591-1499
Practice Address - Country:US
Practice Address - Phone:641-622-3575
Practice Address - Fax:641-622-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1670885OtherVA
IA67088OtherWELLMARK
IA0670885Medicaid
IA1670885OtherVA