Organization
COMMUNITY CARE OF KNOXVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WILLIAM BOEHM JR. (OWNER)
(712) 210-6296
Entity
Organization
Contact information
Practice address
205 N IOWA ST, KNOXVILLE, IA 50138-2833
(641) 842-4618
Mailing address
PO BOX 287, KNOXVILLE, IA 50138-0287
(641) 842-4618
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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