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Organization

POTTAWATTAMIE COUNTY TARGETED MEDICAID CASE MANAGEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUZANNE WATSON MSW (DIRECTOR)
(712) 328-5643
Entity
Organization

Contact information

Practice address
515 5TH AVE, SUITE #113, COUNCIL BLUFFS, IA 51503-0903
(712) 328-5645
(712) 328-5668
Mailing address
515 5TH AVE, SUITE #113, COUNCIL BLUFFS, IA 51503-0903
(712) 328-5645
(712) 328-5668

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0082503
IA
Enumeration date
11/13/2006
Last updated
08/22/2020
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