Provider Demographics
NPI:1639236458
Name:MONROE COUNTY PROFESSIONAL MGMT
Entity Type:Organization
Organization Name:MONROE COUNTY PROFESSIONAL MGMT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-932-5311
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:ALBIA
Mailing Address - State:IA
Mailing Address - Zip Code:52531
Mailing Address - Country:US
Mailing Address - Phone:641-932-5311
Mailing Address - Fax:641-932-3566
Practice Address - Street 1:15A AVE WEST
Practice Address - Street 2:
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531
Practice Address - Country:US
Practice Address - Phone:641-932-5311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0097527Medicaid
IA0233734OtherARO