Provider Demographics
NPI:1083707939
Name:DES MOINES COUNTY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:DES MOINES COUNTY COMMUNITY SERVICES
Other - Org Name:DES MOINES COUNTY CASE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CASE MANAGEMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-754-8556
Mailing Address - Street 1:910 COTTONWOOD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-1994
Mailing Address - Country:US
Mailing Address - Phone:319-754-8556
Mailing Address - Fax:319-754-8854
Practice Address - Street 1:910 COTTONWOOD
Practice Address - Street 2:SUITE 1000
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-1994
Practice Address - Country:US
Practice Address - Phone:319-754-8556
Practice Address - Fax:319-754-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0255034Medicaid
IA0058644Medicaid