Provider Demographics
NPI:1558582684
Name:JOHNSON COUNTY MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES SERVICES
Entity Type:Organization
Organization Name:JOHNSON COUNTY MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL & STATISTICAL SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-339-6169
Mailing Address - Street 1:911 N GOVERNOR ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-5921
Mailing Address - Country:US
Mailing Address - Phone:319-356-6050
Mailing Address - Fax:319-337-9812
Practice Address - Street 1:911 N GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-5921
Practice Address - Country:US
Practice Address - Phone:319-356-6050
Practice Address - Fax:319-337-9812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management