Provider Demographics
NPI:1710024542
Name:WOODBURY COUNTY, IOWA
Entity Type:Organization
Organization Name:WOODBURY COUNTY, IOWA
Other - Org Name:WOODBURY COUNTY SOCIAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:WOODBURY COUNTY CPC
Authorized Official - Prefix:MS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON-PUTTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-279-6459
Mailing Address - Street 1:620 DOUGLAS, RM B5
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101
Mailing Address - Country:US
Mailing Address - Phone:712-279-6459
Mailing Address - Fax:712-279-6558
Practice Address - Street 1:620 DOUGLAS, RM B5
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101
Practice Address - Country:US
Practice Address - Phone:712-279-6459
Practice Address - Fax:712-279-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0056390Medicaid