Provider Demographics
NPI:1326293556
Name:COUNTY OF COOK
Entity type:Organization
Organization Name:COUNTY OF COOK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-387-3606
Mailing Address - Street 1:411 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GRAND MARAIS
Mailing Address - State:MN
Mailing Address - Zip Code:55604-2307
Mailing Address - Country:US
Mailing Address - Phone:218-387-3620
Mailing Address - Fax:218-387-3020
Practice Address - Street 1:411 W 2ND ST
Practice Address - Street 2:
Practice Address - City:GRAND MARAIS
Practice Address - State:MN
Practice Address - Zip Code:55604-2307
Practice Address - Country:US
Practice Address - Phone:218-387-3620
Practice Address - Fax:218-387-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN691555800Medicaid