1003143819 NPI number — MOWER COUNTY HUMAN SERVICES

Table of content: (NPI 1003143819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003143819 NPI number — MOWER COUNTY HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOWER COUNTY HUMAN SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003143819
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 18TH AVE NW STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55912-1988
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-437-9701
Provider Business Mailing Address Fax Number:
507-437-9721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 18TH AVE NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55912-1988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-437-9701
Provider Business Practice Location Address Fax Number:
507-437-9721
Provider Enumeration Date:
11/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LYSNE
Authorized Official First Name:
TODD
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ACCOUNTING/COLLECTIONS SUPERVISOR
Authorized Official Telephone Number:
507-437-9701

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  M00050700 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: M00050700 . This is a "UMPI" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com