Provider Demographics
NPI:1821125394
Name:LINN COUNTY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:LINN COUNTY COMMUNITY SERVICES
Other - Org Name:LINN COUNTY YOUTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:YOUTH SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-892-5733
Mailing Address - Street 1:305 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-1215
Mailing Address - Country:US
Mailing Address - Phone:319-892-5600
Mailing Address - Fax:319-892-5619
Practice Address - Street 1:520 11TH ST NW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-3811
Practice Address - Country:US
Practice Address - Phone:319-892-5733
Practice Address - Fax:319-892-5719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0731786Medicaid