Organization
KEOKUK AREA GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CEVIN T COFFIELD (ADMINISTRATOR)
(319) 524-1871
Entity
Organization
Contact information
Practice address
317 HIGH ST, KEOKUK, IA 52632-5939
(319) 524-1871
Mailing address
317 HIGH ST, KEOKUK, IA 52632-5939
(319) 524-1871
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
56-0091
IA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
56-0091
IA
Other
Enumeration date
06/27/2007
Last updated
05/28/2013
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