Provider Demographics
NPI:1003848557
Name:CATHOLIC CHARITIES OF THE DIOCESE OF WINONA-ROCHESTER
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF WINONA-ROCHESTER
Other - Org Name:CATHOLIC CHARITIES OF SOUTHERN MINNESOTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:FLORENCE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-454-2270
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-0379
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987
Practice Address - Country:US
Practice Address - Phone:507-454-2270
Practice Address - Fax:507-457-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN231930600Medicaid
MN231930600Medicaid