Provider Demographics
NPI:1437584497
Name:LINN COUNTY
Entity Type:Organization
Organization Name:LINN COUNTY
Other - Org Name:OPTIONS OF LINN COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-892-5803
Mailing Address - Street 1:1240 26TH AVENUE CT SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-3402
Mailing Address - Country:US
Mailing Address - Phone:319-892-5606
Mailing Address - Fax:319-892-5619
Practice Address - Street 1:1240 26TH AVENUE CT SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-3402
Practice Address - Country:US
Practice Address - Phone:319-892-5606
Practice Address - Fax:319-892-5619
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0740241251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0740241Medicaid