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Organization

CATHOLIC CHARITIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY EATON LMSW (EXCUTIVE DIRECTOR)
(712) 252-4547
Entity
Organization

Contact information

Practice address
1200 3RD AVE NW, SUITE 1, FORT DODGE, IA 50501-2207
(515) 576-4156
(515) 576-6998
Mailing address
1200 3RD AVE NW, SUITE 1, FORT DODGE, IA 50501-2207
(515) 576-4156
(515) 576-6998

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007700
IA

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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