Provider Demographics
NPI:1427469584
Name:NELSON COUNTY SOCIAL SERVICES
Entity type:Organization
Organization Name:NELSON COUNTY SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-247-2945
Mailing Address - Street 1:210 B AVE W
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAKOTA
Mailing Address - State:ND
Mailing Address - Zip Code:58344-7410
Mailing Address - Country:US
Mailing Address - Phone:701-247-2945
Mailing Address - Fax:701-247-2943
Practice Address - Street 1:210 B AVE W
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKOTA
Practice Address - State:ND
Practice Address - Zip Code:58344-7410
Practice Address - Country:US
Practice Address - Phone:701-247-2945
Practice Address - Fax:701-247-2943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND50742Medicaid