Provider Demographics
NPI:1891848693
Name:CHEROKEE COUNTY CASE MANAGEMENT
Entity Type:Organization
Organization Name:CHEROKEE COUNTY CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEROKEE COUNTY COMMUNITY SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANGLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-225-6700
Mailing Address - Street 1:119 SO 4TH STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012
Mailing Address - Country:US
Mailing Address - Phone:712-225-6700
Mailing Address - Fax:712-225-5839
Practice Address - Street 1:119 SO 4TH STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012
Practice Address - Country:US
Practice Address - Phone:712-225-6700
Practice Address - Fax:712-225-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0136887Medicaid