Organization
FAYETTE COUNTY CASE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL KEUNE (ADMINISTRATOR)
(563) 422-5047
Entity
Organization
Contact information
Practice address
114 N VINE ST, WEST UNION, IA 52175-1302
(563) 422-5047
Mailing address
PO BOX 269, WEST UNION, IA 52175-0269
(563) 422-5047
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0079178
—
IA
Enumeration date
04/13/2007
Last updated
08/22/2020
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