Provider Demographics
NPI:1558432401
Name:WEBSTER COUNTY DISABILITIES ALLIANCE
Entity Type:Organization
Organization Name:WEBSTER COUNTY DISABILITIES ALLIANCE
Other - Org Name:WEBSTER COUNTY CASE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CASE MANAGEMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-573-1483
Mailing Address - Street 1:602 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-3824
Mailing Address - Country:US
Mailing Address - Phone:515-573-1485
Mailing Address - Fax:515-573-1487
Practice Address - Street 1:602 3RD AVE N
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-3824
Practice Address - Country:US
Practice Address - Phone:515-573-1485
Practice Address - Fax:515-573-1487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management