Provider Demographics
NPI:1558413336
Name:CARROLL CO COUNCIL PREV CHILD ABUSE
Entity Type:Organization
Organization Name:CARROLL CO COUNCIL PREV CHILD ABUSE
Other - Org Name:FAMILY RESOURCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC FINANCIAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOWREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-792-6440
Mailing Address - Street 1:502 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2204
Mailing Address - Country:US
Mailing Address - Phone:712-792-6440
Mailing Address - Fax:712-792-3435
Practice Address - Street 1:502 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2204
Practice Address - Country:US
Practice Address - Phone:712-792-6440
Practice Address - Fax:712-792-3435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0118844Medicaid
IA0452672Medicaid
IA0736140Medicaid