Provider Demographics
NPI:1548417660
Name:WARREN COUNTY CASE MANAGEMENT
Entity Type:Organization
Organization Name:WARREN COUNTY CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CPC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIERKING
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:515-961-1145
Mailing Address - Street 1:1011 N JEFFERSON WAY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-1759
Mailing Address - Country:US
Mailing Address - Phone:515-961-1145
Mailing Address - Fax:515-961-1142
Practice Address - Street 1:301 N BUXTON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-1847
Practice Address - Country:US
Practice Address - Phone:515-961-1145
Practice Address - Fax:515-961-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty