Provider Demographics
NPI:1932462496
Name:MARION COUNTY ELDERLY NUTRITION
Entity Type:Organization
Organization Name:MARION COUNTY ELDERLY NUTRITION
Other - Org Name:MARION COUNTY SENIOR NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ALLSPACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-842-6070
Mailing Address - Street 1:308 E MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-2242
Mailing Address - Country:US
Mailing Address - Phone:641-842-6070
Mailing Address - Fax:641-828-2173
Practice Address - Street 1:308 E MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-2242
Practice Address - Country:US
Practice Address - Phone:641-842-6070
Practice Address - Fax:641-828-2173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare