Provider Demographics
NPI:1629161898
Name:DALLAS COUNTY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:DALLAS COUNTY COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-993-1716
Mailing Address - Street 1:902 COURT STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-1448
Mailing Address - Country:US
Mailing Address - Phone:515-993-5869
Mailing Address - Fax:515-993-5872
Practice Address - Street 1:902 COURT STREET
Practice Address - Street 2:SUITE A
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1448
Practice Address - Country:US
Practice Address - Phone:515-993-5869
Practice Address - Fax:515-993-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0746214Medicaid
IA0492975Medicaid
IA0492959Medicaid