1730153693 NPI number — CLIENT COMMUNITY SERVICES, INC.

Table of content: (NPI 1730153693)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730153693 NPI number — CLIENT COMMUNITY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLIENT COMMUNITY SERVICES, INC.
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:
6
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:
1730153693
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
826 5TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORTHINGTON
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56187-2329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-376-3171
Provider Business Mailing Address Fax Number:
507-376-3165

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
826 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORTHINGTON
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56187-2329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-376-3171
Provider Business Practice Location Address Fax Number:
507-376-3165
Provider Enumeration Date:
02/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUHL
Authorized Official First Name:
LOUISE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
ADMINISTRATIVE ASSISTANT
Authorized Official Telephone Number:
507-376-3171

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  801983-2-SILS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 315P00000X , with the licence number: 802803-1-RS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 320900000X , with the licence number: 802833-3-WS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 320900000X , with the licence number: 804586-3-WS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 320900000X , with the licence number: 802834-3-WS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 320900000X , with the licence number: 1013799-3-WS , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 4874528 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1218204 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2586185 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 4253205 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7640200 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0733211 . This is a "DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1684221 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 3752267 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1058207 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 6540180 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 2436256 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 4697278 . This is a "DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 6876773 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0488437 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5123208 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7965206 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 3080200 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0595209 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 7573201 . This is a "MN DHS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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