Provider Demographics
NPI:1003143819
Name:MOWER COUNTY HUMAN SERVICES
Entity Type:Organization
Organization Name:MOWER COUNTY HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING/COLLECTIONS SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:D
Authorized Official - Last Name:LYSNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-437-9701
Mailing Address - Street 1:1301 18TH AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-1988
Mailing Address - Country:US
Mailing Address - Phone:507-437-9701
Mailing Address - Fax:507-437-9721
Practice Address - Street 1:1301 18TH AVE NW STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-1988
Practice Address - Country:US
Practice Address - Phone:507-437-9701
Practice Address - Fax:507-437-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNM00050700251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNM00050700OtherUMPI