Organization
COUNTRY CARE CENTER, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE MCQUEEN (ADMINISTRATOR)
(712) 744-3453
Entity
Organization
Contact information
Practice address
725 HIGHWAY 59, HARLAN, IA 51537-6709
(712) 744-3453
(712) 744-3458
Mailing address
PO BOX 351, HARLAN, IA 51537-0351
(712) 744-3453
(712) 744-3458
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
R390
IA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
R390
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0238410
SCL
IA
01
—
0735639
HCBS WAIVER
IA
01
—
0747410
DAY HABILITATION
IA
05
—
0894006
—
IA
Enumeration date
04/13/2007
Last updated
09/11/2025
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