Organization
MILLS COUNTY
Active
Other names
Rolling Prairie Case Mgmt
Organization subpart
No
Provider details
NPI number
Authorized official
SARA KETCHAM (ADMINISTRATOR)
(712) 623-6541
Entity
Organization
Contact information
Practice address
105 COOLBAUGH, RED OAK, IA 51566
(712) 623-6541
(712) 623-3677
Mailing address
418 SHARP ST, GLENWOOD, IA 51534
(712) 623-6541
(712) 623-3677
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175232
—
IA
Enumeration date
02/01/2007
Last updated
08/22/2020
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