# KEOKUK AREA GROUP HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679779490
- **Authorized official:** MR. CEVIN T COFFIELD (ADMINISTRATOR)
- **Authorized official phone:** (319) 524-1871

## Contact information

- **Practice address:** 317 HIGH ST, KEOKUK, IA 52632-5939
- **Practice address phone:** (319) 524-1871
- **Mailing address:** 317 HIGH ST, KEOKUK, IA 52632-5939
- **Mailing address phone:** (319) 524-1871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 56-0091 | IA | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 56-0091 | IA | — |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 05/28/2013