Provider Demographics
NPI:1770944530
Name:HARRISON COUNTY HOMEMAKER AGENCY
Entity type:Organization
Organization Name:HARRISON COUNTY HOMEMAKER AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-644-3437
Mailing Address - Street 1:111 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:IA
Mailing Address - Zip Code:51546-1370
Mailing Address - Country:US
Mailing Address - Phone:712-644-3437
Mailing Address - Fax:
Practice Address - Street 1:111 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:IA
Practice Address - Zip Code:51546
Practice Address - Country:US
Practice Address - Phone:712-644-3437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health