Organization
KEOKUK AREA GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J JENKINS (QMRP ADMINISTRATOR)
(319) 524-1871
Entity
Organization
Contact information
Practice address
317 HIGH ST, KEOKUK, IA 52632-5939
(319) 524-1871
(319) 524-2612
Mailing address
317 HIGH ST, KEOKUK, IA 52632-5939
(319) 524-1871
(319) 524-2612
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
560091
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0893438
—
IA
Enumeration date
01/02/2007
Last updated
08/22/2020
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